Memorial Hospital of Carbondale

Transcription

Table of Contents
Acknowledgements________________________________________ 2
Introduction and Mission __________________________________ 4
Underlying Themes of our Needs Assessment_ _ ______________ 6
How the Assessment was Conducted _______________________ 8
Executive Summary_ _ _____________________________________ 12
Topic 1: High Impact Clinical and
Preventive Services _____________________________ 15
Topic 2: Access to Care__________________________ 17
Topic 3: Quality and Effectiveness of Care ________ 18
Topic 4: Behavioral Risk Factors__________________ 19
Topic 5: Cancer Disparities_______________________ 20
Our Community__________________________________________ 21
Data Collection Approaches_______________________________ 23
Findings from Community Input Activities__________________ 29
southern illinois healthcare
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Acknowledgements
Southern Illinois Healthcare would like to express our gratitude to
all the members of the advisory teams for their time, insight, and
participation in the Community Health Needs Assessment process.
E x t e r n a l A d v i s o r y Te a m
I n t e r n a l A d v i s o r y Te a m
Kelly Pool – Case Management, Herrin Hospital
Heather Ruhe – Bariatric Program Coordinator, Herrin Hospital – New Life Weight Loss Center
Mary Williams – Quality & Risk Manager, Southern Illinois Medical Services
Cathy Blythe –System Planning Manager
Dr. Ted Grace – Director, SIU Student Health Center
Woody Thorne – Vice President, Community Affairs
Robin Koehl – Director, Franklin-Williamson Bi-county Health Department
Ginger Hilliard – Business Development Manager, Ambulatory & Physician Services
Toni Kay Wright – Health/Nutrition Coordinator, SIUC Head Start
Dr. Joseph Haake – Emergency Department Physician, Memorial Hospital of Carbondale
Miriam Link-Mullison – Director, Jackson County Health Department
Shelly Pierce – Senior Corporate Director, Patient Relations
Kathy Renfro – Executive Director, Carbondale Park District
Amy Niemann – Employee Health, Wellness & Benefits System Manger
Jodi Schoen – Director, Perry County Health Department
Lynn Bree – Director, Corporate Clinical Services
Patsy Jensen – Executive Director, Shawnee Health Services
Amy Wright – Community Benefits Manager
Karen Frietag – Chief Administrative Officer, H Group
Diane Land – Community Health Coordinator
Deborah Pape – H Group
Jo Sanders – Health Ministry Coordinator
Greg Stettler – Director of Continuing Education, John A. Logan College
Heather Troester – School Health Coordinator
Kurt Endebrock – Assistant Regional Superintendent, Franklin/Williamson Regional Office of Education
Scott Seaborn – Administrator, St. Joseph Memorial Hospital
Dr. Quincy Scott – Director, Southern Illinois University Family Medicine, SIU School of Medicine
Terence Farrell – Administrator, Herrin Hospital
Kim Sanders – Director, Center for Rural Health and Social Service Development (CHRSSD)
Donna Boros- Regional Superintendent, Jackson/Perry Regional Office of Education
2 | memorial hospital of carbondale
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1. A description of the community served by Memorial Hospital of Carbondale
Introduction and Mission
2. A description of the process and methods used (including data sources and
timeframes used in the assessment, and analytical methods applied to identify
community health needs).
During 2012, Southern Illinois Healthcare along with a diverse group of community partners
conducted a Community Health Needs Assessment (CHNA) designed to spotlight health and quality
of life issues in our community. The systematic process helped identify issues where changes in
the healthcare delivery system and continued collaboration could improve patient care, preventive
services, and overall health and quality of life.
3. An account of how the broad interests of the community served were obtained and
incorporated into the assessment.
4. A prioritized description of the health needs identified
5. A description of existing health care facilities and other resources available to meet the
community health needs identified through the CHNA.
Southern Illinois Healthcare is a not-for-profit integrated health system. The SIH system is made up
of three hospitals – Memorial Hospital of Carbondale (MHC) in Carbondale, Herrin Hospital (Herrin)
inpatient hospitals, the system includes two clinics, two physician professional buildings, an urgent
Collaborative Approach
care clinic, and dedicated neurology, cancer, heart, sleep and rehabilitation centers.
Throughout our CHNA process, we incorporated the broad interests of the community we serve by
in Herrin, and St. Joseph Memorial Hospital (SJMH) in Murphysboro, Illinois. In addition to the three
The nearly 3,000 employees at Southern Illinois Healthcare are dedicated to promoting the health and
well-being of all the people in the communities we serve. This mission is guided by our core values.
•C
ompassion Responding to the feelings and needs of each person with kindness, concern
and empathy
•C
ollaboration Communicating and working with others for the benefit of all
• Quality Striving for excellence in all we do
•S
tewardship Responsibly using, preserving and enhancing our human and material resources
as a not-for-profit community controlled organization
• Integrity Adhering to strong moral and ethical principles in all we do
• Accountability Holding ourselves and those around us responsible for living the values and
achieving the vision of Southern Illinois Healthcare
• Respect Recognizing and valuing the dignity and uniqueness of each person
including input from residents, patient groups, health care practitioners, local health departments,
social services providers, and other community organizations and partners. This collaborative
approach aligns work efforts, avoids duplication, and increases efficiencies. (NACCHO, 2011)
Participants contributed to this assessment by:
•Identifying and prioritizing needs;
•Highlighting current successful and ongoing activities;
•Identifying gaps where attention is needed;
•Fostering collaboration, pursuing opportunities for
innovation and sustainability;
•Developing plans to address significant community
health issues.
The CHNA process was guided by a Steering Committee composed of an internal team of SIH
representatives and an external team of community stakeholders knowledgeable about health, needs
assessment, and the local community (see list of committee members on page 2). The Steering
Purpose
Committee’s work was facilitated by the SIH Community Benefits Department staff.
The CHNA was conducted as part of Southern Illinois Healthcare’s Community Benefits planning process
How to Use this Report
to identify the most important health issues in our area, particularly for vulnerable and under-represented
populations, to ensure that programs and services closely match the priorities and needs of the community,
and to strategically address those needs to improve the health of the communities we serve.
This CHNA Report and supporting appendices are specific to Memorial Hospital of Carbondale.
Health issues and needs are highlighted to provide information and garner support from those in
In addition, in anticipation of IRS Notice 2011-52 relating to community health needs assessment (“CHNA”)
the community who may want to support or otherwise become involved. We believe that joining
required by Internal Revenue Code (“Code”) Section 501(r)(3), we have prepared this report to include:
strengths and leveraging resources in such local efforts, will increase our community capacity,
helping us to make successful and sustainable improvements in health and quality of life.
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Underlying Themes of our
Needs Assessment
Focus on prevention
Communicate needs
and advocate for health
enhancing policies, systems,
and environments
By identifying and highlighting health issues and gaps in care
Preventing disease before it starts is an important part
along with our plans to address them, we hope to enhance
of helping people live longer, healthier and better quality
the public’s understanding about the links between behaviors,
lives. Better preventive care also helps avoid unnecessary
risk factors, social determinants of health, policies and
healthcare and helps lessen costs. Prevention, however,
systems, and the long-term health status and quality of life
goes beyond providing people with information about
for our community. Aligning our indicators with national health
healthy behaviors such as how diet, exercise, tobacco, and
improvement efforts allows us to establish a comparative
alcohol affect health. It is also important for communities
picture of the health in our community and provides for
to create policies, systems, and environmental supports
consistent measurement of our progress over time.
that make healthy actions and choices easy, accessible and
affordable. Many of the strongest predictors of health and
Housing, transportation, education, employment, access to
Leveraging opportunities
healthy food, and quality healthcare are all factors that can
Many of the issues identified require concerted and
have a major impact on the physical and mental health of
coordinated effort from community partners. Hospitals,
our community members.
health systems, health departments and school systems
quality of life (wellness) are not within an individual’s control.
are uniquely positioned to coordinate prevention efforts at
Reducing health disparities
the individual, organizational, community and policy levels
by bringing attention to health issues through advocacy,
health supportive policies and practices, in addition to
The range of personal, social, economic, and environmental factors that influence health often fall
direct provision of services. This assessment serves as an
outside the hospital or clinic walls, yet their inter-relationship affects individual and community health.
implementation and community benefits planning document
These factors disproportionately affect vulnerable and underrepresented populations and adversely
for Memorial Hospital of Carbondale specifically, other local
affect quality of life and health for all of us. Because of this, interventions that are community-
healthcare and service providers in general, and should serve
based and target multiple determinants of health are most likely to be effective. Engaging allies
as a broader call to action for the community to become
from outside the traditional boundaries of healthcare facilities and the public health sector such as
involved in improving health.
1) Attain high-quality,
longer lives free of
preventable disease,
disability, injury, and
premature death.
2) Achieve health
equity, eliminate
disparities, and
improve the health of
all groups.
3) Create social
and physical
environments that
promote health.
4) Promote quality
of life, healthy
development, and
healthy behaviors
across all life stages.
Source: U.S. Department of Health and Human
Services. Office of Disease Prevention and
Health Promotion. Healthy People 2020. Washington, DC. Available at www.healthypeople.
gov. Accessed August 17, 2012.
education, social work, legal aid, housing, transportation, agriculture, and environment is essential to
improving population health.
“It is unreasonable to expect that people will change their behavior so easily when so many
forces in the social, cultural, and physical environment conspire against change. If successful
programs are to be developed to prevent disease and improve health, attention must be given
not only to the behavior of individuals, but also to the environmental context within which
people live.” (IOM, 2000)
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How the Assessment
was Conducted
In February of 2012, internal and external advisory teams were convened to conduct a review
of existing need assessments available at the local/state/national level for the SIH service area
(Jackson, Franklin, Williamson, Union, Saline, Johnson, and Perry Counties). Areas of focus included
demographics, vulnerable populations, County Health Rankings, leading causes of death, the Illinois
1. Established the CHNA Infrastructure.
Department of Public Health 2010 State Health Improvement Plan, and critical priorities of Healthy
People 2020. Each team established a charter to guide their activities.
Internal team
Internal Team Charter: The SIH Community Health Needs Assessment Internal Advisory Team

preliminary priorities for further investigation and, following review by the External Community Health
Ensure broad representation of community
Needs Assessment Advisory Group, make recommendations for final priorities to be addressed in
exists to review data on community health needs. Using the defined criteria, the team will select
External team
the SIH Community Benefits Plan.

Align with national indicators and benchmarks - Healthy People 2020
Focus on determinants of health - County Health Rankings framework
Healthy Communities Institute - data collection and communicating findings/plans
A similar charter was established for the External team: The External Community Health Needs
Assessment Advisory Groups exist to help Southern Illinois Healthcare evaluate the initial priorities
selected by the SIH Community Health Needs Assessment Internal Advisory Team. These groups
will convene in each SIH hospital and review existing data and offer insights into community issues
affecting that data. They will help identify local community assets and gaps in the priority areas, and
will offer advice on which issues are the highest priority.
In July of 2012, the infrastructure was defined further to ensure broad representation of the
community, to align with national indicators and benchmarks such as Healthy People 2020, to focus
on determinants of health using the County Health Rankings framework, and incorporating use of
the Healthy Communities Institute – CHNA web-based tool for initial data collection and publically
communicating the findings and implementation plans.
In September of 2012, the advisory groups were presented with initial needs assessment data and
www.healthypeople.gov
Healthy People 2020 is the
10-year national agenda for
given the opportunity to discuss and prioritize health issues. At this time advisory team members
www.countyhealthrankings.org
The 2012 County Health
also began identifying existing programs and services that address the needs identified or where
www.healthycommunitiesinstitute.
gaps in care or services existed. This approach was consistent with the National Association of City
com
and County Health Officials’ (2011) recommendation to align works efforts, leverage resources, avoid
duplication and increase efficiencies in addressing population health issues.
improving the health of all
Rankings for Illinois were
Americans.
used as a framework to
A web-based tool designed to
measure and understand
help hospitals, public health
how healthy our community
departments, and other
residents are.
community partners access
HP 2020 provides
objectives and benchmarks
for nationwide health
improvement priorities.
We considered factors
such as individual health
behaviors, environment,
education, income, and
systems of care to assess
our community needs and
develop an implementation
plan.
indicator data and promising
2. Defined the purpose and scope
of the assessment.
practices. It helps promote
The purpose of the CHNA was to identify the most important health issues, set programming
transparency, identify and
priorities, align work efforts with community partners, and provide information and garner support
communicate priorities, and
from those in the community who may want to support or otherwise become involved in improving
compare/ track progress for
health.
timely and relevant health
improving the local healthcare
system.
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The scope of the assessment includes a separate
SIH hospital. Memorial Hospital of Carbondale’s
4. Selected priorities.
seven-county primary service area was obtained
The priorities identified are intended to be integrated into the Community Benefits strategic planning
by calculating the total number of inpatient and
process to ensure that our programs and services closely match the priorities and needs of the
outpatient “encounters” by zip code of residence for
community, and to strategically address those needs to improve the health of the communities we
Fiscal year 2012 (April 1, 2011 to March 31, 2012).
serve. To select priorities, health issues were evaluated according to several criteria.
service area and needs assessment report for each
After determining where the majority --at least
• Overall impact – how much the issue affects health and quality life, or contributes to multiple
80% of total hospital volume of patients came
health-related issues.
from, which cities and counties were represented,
• Magnitude of the problem – how many lives are affected in our community, and how does our
and plotting them on a map, our primary service
community compare to national benchmarks and goals.
area was verified to include: Jackson, Franklin,
Williamson, Union, Saline, Johnson, and Perry
• Severity – the degree to which the issues leads to pre-mature morbidity and mortality.
counties.
3. Collected and analyzed data.
Our CHNA process included a primary survey of our community’s health priorities, a patient focus
• Ability and interest of the community to effectively address the issue.
5. Document and communicate results.
This document is the summary of the CHNA
group, and facilitated group discussions with local public health department staff, health and social
process and findings. It is made available to the
service providers, and other community members. Active participation in local Healthy Community
public to provide information and engage the
Coalitions also provided insight into the needs and priorities of our community members.
community in taking an active part in improving
Information from multiple local, state and nationally recognized secondary sources was compiled
the health and well-being of our community. It
using the Healthy Communities Institutes tool, Healthy People 2020 goals, and a framework of
can be accessed electronically on our website
categories consistent with County Health Rankings to include: health systems, socioeconomic
at http://www.sih.net/home.nsf/content/
factors, physical environment and health behaviors.
CommunityBenefits.
To assess potential disparities and ensure the needs of vulnerable populations were taken into
hospitalizations and emergency department
6. Implementation planning and
monitoring progress.
utilization are likely to occur. By demonstrating
The priority areas identified through this needs assessment will be used to focus community benefits
the link between community need, access
planning for the next three years. Our Community Health Snapshot will provide dashboard data to
to care, and preventable hospitalizations
gauge our progress and Promising Practices resources to engage the community with suggested
at the zip code level, Memorial Hospital of
interventions that have been tested and shared by others.
account, the Community Need Index (CNI) was used highlighting “High Need” zip codes where a
composite score of socioeconomic factors
is such that barriers to medical care, high
Carbondale can ensure resources are focused
where they are most needed.
Using this framework provided valuable
community-level information regarding underlying behavioral and social determinants of health, as
well as access and barriers to health improvement. A complete listing of measures, sources, and
timeframes used is included in Appendix 1 - Health Profile_SIH System Report.
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Executive Summary
area. Unemployment, poverty, food insecurity, access to care issues, and financial barriers adversely
affect health in the region, as shown through emergency department utilization for ambulatory
care sensitive conditions. Access to care especially for oral and mental health services remains an
important issue. Approximately half (47%, n=238,276) of MHC service area residents are either on
Hi sto ry
Medicaid or uninsured.
Throughout 2012, Southern Illinois Healthcare and a group of community partners collaborated to
In addition to reviewing existing data sources and local Illinois Project for Local Assessment of Needs
conduct a Community Health Needs Assessment (CHNA). The infrastructure included a Steering
(IPLANs), SIH used three methods for incorporating broad community input 1) External Advisory
Committee, composed of internal and external teams from within the health system, from local
Team, 2) Patient Focus Group and 3) Community Input Survey. Themes that surfaced were consistent
health departments, healthcare providers, community and faith-based leaders, patients, social
among the different input sources and aligned with the Health Profile data for our service area. Health
service providers, and others with expertise in public health and knowledge of the local community.
behaviors that contribute to overweight/obesity, cardiovascular disease, and preventive care were
The role of the Steering Committee was to review the health and community data, and provide
concerns. Chronic disease management, care coordination and adequate access to care (for dental
This CHNA
Report brings together the community health profile data and analysis,
health provider identified priorities, resident identified priorities, and steering
committee meeting discussions and ranking results that occurred throughout
the process of identifying our community health priorities.
and mental/behavioral health services) were identified as health issues.
input and recommendations for the most pressing priorities for the service area.
SIH will use the findings to shape a strategic implementation plan targeting activities where they
can have the most impact. This report and the appendix are made available to our community as
a resource for individuals, local and regional organizations, health and service agencies and other
stakeholders that have a vested interested in addressing the health and well-being of vulnerable
Data was collected and assessed using a framework of
populations. By continuing the momentum generated through the CHNA process and fostering
behavioral and social determinants of health consistent
collaboration, we can reduce duplication of efforts, share existing resources, seek opportunities for
with County Health Rankings methodology and addressing
innovation, and best serve the health needs of our community.
the Healthy People 2020 overarching goals for national
health improvement. Attention was given to identifying
disparities and high need areas, specifically for vulnerable
and underserved populations. The range of indicators
showed many health and social factors affecting health in
communities within the MHC service area.
W h at d i d t he d at a s h o w ?
Overall Jackson County, particularly zip code 62901 and the communities
in around the city of Murphysboro and Marion in Williamson County are
the highest need areas and are disproportionately affected by socioeconomic
barriers to care. The entire MHC service area has high overweight/obesity, cardiovascular
disease, and less that recommended use of preventive health
C H NA I d e n t i f i e d
P r i o r i t y H e a lt h
I ss ue s
The goal of the Community Health
Needs Assessment, in part, was to
identify issues where changes in
the health care delivery systems
can improve both patient care and
preventive services for those at risk
for health problems. This section
presents an overview of the findings
and recommended priority areas based on those findings.
care such as screenings and immunizations. Individual health
Through facilitated discussions and prioritization processes, SIH and the CHNA Steering Committee
behaviors such as alcohol and tobacco use and other high risk
analyzed information in the Health Profile_SIH System Report (Appendix 1).
behaviors are higher than state and national comparisons.
Disparities in rates of all types of Cancer in Franklin,
Williamson, Johnson and Saline Counties, colorectal cancer
in five out of the seven counties, and lung cancer in Franklin,
Williamson and Saline counties are evident in the service
Internal and external team multi-round ranking activities, focus group feedback and community
member survey results helped identify five priority issues for the community. The priorities identified
are 1) high impact clinical and preventive services, 2) access to care, 3) quality and effectiveness of
care, 4) behavioral risk factors, and 5) cancer disparities.
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Topic 1: High Impact Clinical
and Preventive Services
Topic 1: High Impact Clinical
and Preventive Services
De f i n e d :
Preventive care (services) refers to recommended immunizations and routine
• PCMH (prevention and chronic disease management)
screenings that help prevent disease or provide early detection of disease.
• Case Management
“High impact” refers to both clinical care management and preventive
• Clinical Care
services that can help protect individuals and communities from the most
• Community Based Interventions and Services
prevalent causes of disease such as cancer, heart disease and stroke,
diabetes, influenza and pneumonia, and other infectious diseases.
Topic 2: Access to Care
The s t o r y b eh i n d t he p r o b l e m :
Many diseases are more treatable in their earlier stages and participating
• Substance Abuse and Mental Health Services
in preventive services helps reduce the risk of illness, disability and premature death, and prevents
• Oral/Dental Health
unnecessary and costly medical care. Despite these reasons, many in our community continue to go
• Disparities/vulnerable populations
without recommended clinical preventive services. In addition, good care coordination and patient
self-management through a primary medical home, promotes improved patient outcomes, and helps
Topic 3: Quality and
Effectiveness of Care
reduce unnecessary readmissions.
K e y F i ndi ng s
The percentage of adults in the MHC service area who have ever been told they have diabetes is
about 1 in 8. Diabetes is a leading cause of death in our community and was responsible for 2,741
deaths in Illinois in 2009. It has a harmful effect on major organ systems, is the leading cause of
• AMI, CHF, Pneumonia
end-stage renal disease and blindness among adults, and contributes to cerebrovascular diseases
• Coordinated care for chronic conditions (CHF, COPD, Diabetes)
(including ischemic heart disease and stroke). One of the key indicators of diabetes management
is regular blood glucose monitoring. Both Franklin and Jackson Counties have higher age-adjusted
Topic 4: Behavioral Risk
Factors
diabetes-related mortality rates than the U.S. comparison. Although Jackson County shows a lower
percentage of adults reporting that they have ever been told they have diabetes, this likely underrepresents the burden of disease for this area. Jackson County, particularly Carbondale zip code
62901, the city of Murphysboro, and north into Perry County have high socio-economic barriers to
care which may contribute to under-diagnosis and detection.
• Physical activity, nutrition, smoking, obesity to address:
Cardiovascular Health
Respiratory Diseases
Diabetes
Topic 5: Cancer Disparities
Adults with Diabetes
(not including women with diagnosed with diabetes during a pregnancy).
County
Adults with
Diabetes
Adults with Diabetes who had
Blood Glucose Test in past year
Diabetes Mortality
Age-adjusted Rate*
Jackson
5.0%
50.6%
30.1
Franklin
12.9%
59.2%
55.5
Perry
11.2%
59.3%
N/A
Source: Illinios Behavoral Risk Factor Surveillance System, 2007-2009
*Age-adjusted rates per 100,000 U.S. standard popularion (based on the 2000 census, estimated as of July 1, 2008)
Compare to U.S. Age-Adjusted mortality rate of 21.8/100,000
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I n f l ue n z a a nd p ne umoni a
The age-adjusted mortality rate from influenza and pneumonia is high in Franklin, Saline and
Williamson Counties when compared to Illinois (17.3 per 100,000) and the U.S. (16.9/100,000). Saline
Topic 2: Access to Care
County had the highest age-adjusted mortality rate, however had the highest percent of adults
vaccinated for both influenza and pneumonia.
De f i n e d :
County
Influenza/Pneumonia
Adults with Influenza
Age-adjusted
vaccination in the last year
Mortality Rate
Franklin
21.9
34.0
25.1
Saline
34.1
44.8
34.7
Williamson
24.6
48.9
36.6
Adults who ever had a
pneumonia vaccination
Access to health care refers to the availability and affordability of primary, specialty and emergency
care. It refers not only to the presence of medical professionals and facilities, but also insurance
coverage, transportation, wait times for appointments, low health literacy, and financial barriers to
care such as inability to pay co-payments and deductibles.
The s t o r y b eh i n d t he
problem:
Source: IDPH, ICHS, 3rd & 4th Round County BRFS, 2007-2009
*Age-adjusted rates per 100,000 U.S. standard popularion (based on the 2000 census, estimated as of July 1, 2008)
Compare to U.S. Age-Adjusted mortality rate of 16.9/100,000
When there is inadequate capacity or availability within
the primary care system, patients may use emergency
P r e v e n ta b l e H o s p i ta l S tay s :
departments more frequently. Many of these care needs
Medicare Population
such as behavioral and mental health, and oral/dental
health conditions can be treated more appropriately and
A review of utilization data (both
Discharges per
1,000 Medicare
enrollees
inpatient and emergency department), shows
that access of MHC services for primary
County
care treatable conditions is elevated in our
Jackson
70
area. It is likely that these utilization rates are
Franklin
91
due to differences in access and/or quality
Williamson
106
Perry
109
(disease prevalence) in the community. For
Johnson
82
comparison, the 90th percentile benchmark
Union
92
nationally is 49 per 1,000 and in Illinois is 77
Saline
117
as well as poorer underlying health status
per 1,000.
affordably in an outpatient setting. Care solutions are
needed to ensure patients are getting quality care in the
Status
Source: Couty Health Rankings, 2009, Comparison U.S. Counties
appropriate setting.
K e y F i ndi ng s :
KEY INDICATORS TO
An analysis of patients who accessed Emergency
TRACK PROGRESS:
Department services five or more times during the year
(5+ visits to ED in FY12) showed that many of the
conditions seen at MHC were for non-emergent and
primary care treatable conditions. This is an indication
that the ED is being used for primary care. The most
frequent diagnoses seen in the ED included abdominal
pain, urinary tract infections, migraine, headache,
KEY INDICATORS TO TRACK PROGRESS:
Diabetes
Preventive Screenings
• A1c performed annually
• Colorectal cancer screening
• LDL performed annually
• Breast cancer screening/mammography
• Nephropathy screening annually
• Cervical cancer screening
• Smoking Cessation Counseling annually
• Influenza vaccination annually
• Pneumonia vaccination – once prior to
age 65, repeat once for 65+
Adult Immunizations
• Influenza vaccination annually
constipation, back pain, chest pain and acute upper
respiratory infections, dental disorders, substance
ED Utilization
• Substance Abuse
• Mental Health
• Oral/Dental Health
• Blood-related Illness
(vulnerable populations)
• Ambulatory care sensitive conditions
abuse and mental health diagnoses.
In addition, the MHC service area is located in a Medically Underserved Area and Health Provider
Shortage area for primary, dental, and mental health providers. Designation maps are provided in
Health Profile—SIH System Report (Appendix 1).
• Pneumonia vaccination 65+ once
30-Day Readmissions
• CHF, COPD, Diabetes (Chronic Disease Management)
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Topic 3: Quality and
Topic 4: Behavioral
Risk Factors
De f i n e d :
De f i n e d :
Quality and effectiveness of care refers to
Risk factors for chronic diseases such as cardiovascular disease (CVD), respiratory diseases, diabetes,
measures of health care quality that demonstrate
and cancer include smoking, physical inactivity, hypertension, and overweight/obesity.
compliance with clinical care guidelines, good
chronic disease management, and hospital
readmission rates. Quality and effectiveness
Cardiovascular disease and chronic lower respiratory diseases are two of the leading causes of death
of care measures often incorporate publically
in our community and nationwide. Diabetes is also a medical risk factor contributing to CVD. Losing
reported indicators.
weight and maintaining a healthy weight through physical activity, healthy eating, and not smoking
The s t o r y b eh i n d
t he p r o b l e m :
Some readmissions are planned as a part of a specific
treatment plan, or are medically appropriate due to
a change in condition or health status. More often
can help prevent and control these diseases.
KEY INDICATORS TO
TRACK PROGRESS:
At least one in five adults in our primary service
30-Day Readmissions
however, hospital readmissions within 30-days are
• AMI, CHF, Pneumonia,
being thought of as avoidable and as indicators of poor
COPD, diabetes
care, missed opportunities to coordinate care, or other
breakdowns along the continuum of care.
ED Utilization
• Sickle Cell Anemia (crisis)
Southern Illinois Healthcare’s system-wide priorities for
KEY INDICATORS TO
TRACK PROGRESS:
• Physical Activity
area smokes. Smoking is recognized as the single
•Hypertension
most preventable cause of premature morbidity
and loss of life in the U.S. The percentage of adults
who smoke in Franklin, Jackson, Perry and Williamson
County has remained steady from 2007 to 2009. Johnson
•Smoking
•Obesity
•Nutrition
and Saline counties have seen slight decreases in smoking
rates. The percentage of adults who smoke in Union county is increasing.
a d u l t s wh o s m o ke :
exceptional care, patient transitions, and care coordination include chronic obstructive pulmonary
disease (COPD), acute myocardial infarction (AMI), congestive heart failure (CHF), pneumonia,
septicemia, diabetes, Sickle Cell Anemia, and major respiratory infections and inflammations.
County
Status
Percent
Jackson
28.3
Franklin
25.8
Williamson
24.0
Perry
27.4
Johnson
21.7
Union
27.7
Saline
20.4
Source: Illinois Behavioral Risk Surveillance System, 2007-2009
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Topic 5: Cancer Disparities
Most of our
patients live in
these cities:
Our Community
Carbondale (62901)
Carterville
7 County Service Area
DuQuoin
Southern Illinois has a cultural identity separate from the rest of Illinois. The
Murphysboro
De f i n e d :
Cancer incidence rates include the number of new cases of cancer observed in a given period of time
based on the population within a community (usually a defined geographic) region.
The burden of cancer in the MHC service area and the implications for screening and follow-up that
are necessary to improve health status and cancer outcomes in our community are a priority. Cancer
care includes the prevention of behavioral risk factors,
KEY INDICATORS TO
screening and early detection, timely access to quality
TRACK PROGRESS:
care, patient and family support and involvement in
healthcare decision making and end-of life planning.
Marion
Anna
Southern Illinois has an abundance of outdoor recreational opportunities,
Carbondale (62902)
lakes, national forest, biking and hiking trails, fishing and camping.
West Frankfort
Incidence Rates
Desoto
•Lung & Bronchus
Cobden
• Breast Cancer
Cancer is the second leading cause of death in our
•Colorectal Cancer
Benton
community. The incidence rates in Southern Illinois are
•All cancer
Carbondale (62903)
Preventive Screening
Makanda
Smoking
Pinckneyville
to 3,081 U.S. Counties shows several locations in our
service area have higher cancer incidence rates.
acute care and critical access hospitals, airports, and many historical sites.
Herrin
consistently higher than the rest of Illinois. A comparison
area houses multiple community colleges, a research university, multiple

Elkville
Indicators of “Red” on the colored gauge represent the bottom or “worst” quartile when compared
to other regions. Modifiable behaviors (risk factors) such as smoking, obesity, and sedentary life
styles contribute to cancer. Several counties in the MHC Service Area have elevated rates for these
indicators. Approximately 3 out of 10 adults smoke and two-thirds are overweight or obese.
Jonesboro
Johnston City
Harrisburg
Ava
County
Lung &
Bronchus
Breast
Cancer
Colorectal
Cancer
Goreville
All
Cancer
Dongola
Franklin
111.0
120.4
63.2
548.7
Jackson
67.0
115.5
55.7
474.8
Perry
74.5
115.8
59.8
476.2
Eldorado
Williamson
92.3
122.8
54.7
506.2
Johnson
Chester
82.0
120.5
59.1
542.8
Union
82.0
109.3
46.6
439.3
Saline
95.0
142.6
59.2
501.0
Source: National Cancer Institute, State Cancer Profiles (2005-2009)
Age-adjusted incidence rate/100,000; comparison 3,081 U.S. Counties
Christopher
Tamaroa
Vienna
Royalton
*descending order by volume

Greater than
80% of MHC
inpatient and
outpatient
visits came
from residents
of these seven
counties.


 
 
(Fiscal Year: 2012)
Rur a l p r o f i l e
Our service area includes rural and very rural areas largely separated by
the Shawnee National Forrest and farmland. While formerly dispersed, the
region is becoming more centralized around the “Route 13 Corridor” and
the city of Carbondale. The number of persons per square mile in the MHC
service area is considerably less than Illinois overall.
| 21
Geography QuickFacts
Land area in square miles, 2010
Persons per square mile, 2010
Illinois
55,518.93
231.1
Jackson
584.08
103.1
Franklin
408.89
96.8
Williamson
420.15
157.9
Perry
441.76
50.6
Johnson
343.92
36.6
Union
413.46
43.1
Saline
379.82
65.6
Data Collection Approaches
Sec o n d a r y
Secondary data sources included health and social indicators from County Health Rankings, Illinois
Department of Public Health, American Communities Survey, the Decennial Census, the Behavioral
Source: US Census Bureau State & County QuickFacts
Risk Factor Surveillance System (BRFSS), Illinois State Board of Education, Illinois Department
of Healthcare and Family Services, Illinois Department of Children and Family Services, U.S.
C o m m u n i t y P r o f i l e : De m o g r a ph i c s
Population
Department of Agriculture Food Environment Atlas, Economic Research Service, National Cancer
Institute, Community Need Index, US Census Bureau State & County QuickFacts, Bureau of Labor
Statistics, Centers for Disease Control and Prevention, U.S. Environmental Protection Agency,
Memorial Hospital of Carbondale is situated in the most densely populated
area in Southern Illinois. The Carbondale-Marion-Herrin Illinois Combined
Statistical Area, a two county stretch, is home to approximately 125,000
Substance Abuse and Mental Health Services Administration (SAMHSA), National Surveyon Drug
Use and Health (NSDUH), National Center for Health Statistics, Illinois Youth Survey, IPLANs, and SIH
internal systems data.
residents.
The seven counties included in our primary service area, Franklin, Jackson, Johnson, Perry, Saline,
P r i ma ry
Union, and Williamson are home to an estimated 243,789 people. Collectively the region experienced
SIH used multiple primary data sources to collect community perceptions of health and health
a slight increase in total population between 2000 and 2010. While the majority (12 out of the
service needs. Community input activities included: a community input survey, a patient focus group,
southernmost 17) southern Illinois counties saw a population decline in the last 10 years, five
active participation in Healthy Community Coalitions and the Healthy Southern Illinois Delta Network,
counties did have population increases. Three of those five counties (Jackson, Williamson, Franklin,
and External and Internal Advisory Team mutli-round ranking activities.
Massac and Pope) experiencing a growth in population are within the MHC service area.
Findings from Secondary Health Data
The Health Profile_SIH System Report (Appendix 1) provides a comprehensive look at the health
factors and outcomes in the SIH service area. Indicators were selected using the County Health
Ranking framework. Data is generally presented at the zip code and county levels with some
regional, state, and national comparisons. After analyzing inpatient and outpatient encounter data for
the previous year, it was determined that at least 80 percent of Memorial Hospital of Carbondale’s
patients resided in one of seven counties.
Source: U.S. Census Bureau, 2010 Census.
| 23
De m o g r a ph i c s
Socio-Economic Status
Age profile
Many of the communities in the MHC service area have high rates of poverty, lower median incomes
In general, the population in MHC’s primary service area is older, predominantly white, and equally
distributed between genders. The median age in Illinois (2010) was 36.6 years of age and the U.S. as
a whole was 37.2. With the exception of Jackson County, the median age in our area is slightly higher.
The average percentage of population age 65+ in Illinois overall is 12.7%. With the exception of
Jackson county, these Southern Illinois counties have a higher percentage of adults age 65 years and
older than the Illinois average. Having a larger percentage of older adults has implications for service
delivery and demand.
Median age (years)
% Under age 5
% Under age 18
% Age 65+
Illinois
36.6
6.4%
24.1%
12.7%
Franklin
41.8
6.0%
22.7%
18.3%
Jackson
29.1
5.1%
17.3%
11.8%
Johnson
42.2
4.4%
18.8%
17.6%
Perry
39.4
5.1%
20.5%
15.9%
Saline
41.7
5.9%
22.8%
18.5%
Union
42.9
5.6%
21.3%
18.5%
Williamson
40.1
6.0%
22.0%
16.5%
than state and national comparisons, and a high percentage of children living in poverty. The annual
median family income in our area ranges from a low of $32, 169 in Jackson County to a high of
$41,619 in Johnson County (Illinois’ $55,735, and U.S. $51,914). The percentage of children living
below the poverty level in our community is greater than state (20 percent) and national (around
17 percent) comparisons. Children living in poverty are more likely to have physical, behavioral, and
emotional health problems. It has been shown that children living in poverty have lower achievement
test scores, and are less likely to graduate from high school (affecting their future employment
opportunities and earning potential).
Source: U.S. Census Bureau, 2010 Census; People QuickFacts.
Source: American Community Survey, 2006-2010, 5-year estimates based on data from 3,143 U.S. counties and county equivalents.
Local area unemployment ranges from 8.8% in Jackson and Williamson counties to around 11%
in Franklin, Perry, Union, and Johnson counties. These rates are higher than the September 2012
national unemployment rate of 7.8 percent, and the overall unemployment rate (seasonally adjusted)
for Illinois at 8.8 percent. (Source: The U.S. Bureau of Labor Statistics. Sept/Oct, 2012) High
unemployment has personal and societal impacts, affecting access to health care, straining financial
and emotional support systems, and contributes to decreased quality of life.
Education
In the MHC community, overall, graduation
rates vary greatly, ranging from 70 to 96.8
percent. Over half of the schools ar lower
than the Illinois State Board of Education
School Report Card which indicates 82
percent of Illinois students graduate from
high school with a regular diploma in four
years. Approximately 18 percent of people
over age 25 in the MHC service area, have
a bachelors degree or higher. There are
gaps in local high school graduation rate by
race/ethnicity.
Source: Illinois State Board of Education School Report Cards, 2011-2012. www.isbe.net/assessment/report-card.htm
| 25
Food Access and Food Security
Natality
A large number of community residents have limited access to healthy foods at a supermarket or
Teen births are an indicator of the reproductive health and health risk behavior or a community.
large grocery store. Based on both low-income and low-access community criteria, much of the
Adolescents are less likely to seek prenatal care, have more adverse pregnancy outcomes, are more
service area for Memorial Hospital of Carbondale is located in food desert areas. These areas have
likely to deliver low-birth weight babies, and face other social and economic barriers. Three counties
a lack of access to supermarkets and other venues where healthy foods are available for sale. Food
in the MHC service area have higher rates of teen births in comparison to 102 Illinois counties.
desert areas are associated with a lower quality diet and increased risk of obesity. (CDC, 2011)
A yellow status indicator represents the 25th to 50th percentile. Union county is indicated in red,
In the U.S., one in eight adults (approximately 12.5 percent of the adult population) and one in four
children (25 percent) were using SNAP benefits as of 2009. Each county in the MHC service area
has a significantly higher percentage of the population meeting federal poverty guidelines and
representing the lowest or “worst” quartile.
Percentage of all live births to females under
18 years of age Comparison: IL Counties
The percentage of low birth weight
babies in Johnson, Perry, and Union
participating in the Supplemental Nutrition Assistance Program (SNAP). SNAP participations and
counties is elevated when compared
the number of children eligible for free and reduced-price lunch programs indicate poverty and food
to the rest of Illinois. Pre-term and
insecurity in our community.
Our Counties
Status
Percent
low birth weight babies are more
likely to require specialized medical
Franklin
4.0%
care, and have higher risks of death
Williamson
3.3%
and long-term disability.
Union
6.7%
Source: Illinois Department of Public Health, 2009.
Babies with Low Birth Weight (<2500 grams)
Comparison: IL Counties
Our Counties
Source: U.S. Department of Agriculture - Food Environment Atlas, 2007; http://www.ers.usda.gov/FoodAtlas/downloadData.htm
Status
Percent
Johnson
10.6%
Perry
9.6%
Union
9.8%
Health Status
Mortality rates
Most people in our area consider their general health to be excellent/very good or good/fair. Over
It is clear that many of the leading
half say they have had no days in the last year when their physical health was not good. About one in
causes of death can be attributed to
five people in our community say that they have had between 8-30 days in the last year when their
a core group of preventable causes
mental health was not good. Another one in five people say they have had at least one day, and up to
including: Alcohol, tobacco, and
one week in the last year when their mental health was not good.
other drug use, physical inactivity,
General Health
Status
poor nutrition, environmental
influences, preventable injuries, and
Days Mental
Health Not Good
Days Physical
Health Not Good
mental health. Causes of death for
our community are consistent with
Illinois’ and national trends. The top
causes of death in our community
are cardiovascular disease, cancer,
chronic lower respiratory disease,
and stroke.
Source: IDPH Health Statistics, http://www.idph.state.il.us/health/bdmd/deathcauses_09.htm
| 27
Health Care Access and Coverage
All seven counties in the MHC primary service area are in medically underserved areas and Health
Professional Shortage Areas (HPSAs). This means there is a known shortage of primary medical
care, dental or mental health providers, and there may be geographic, demographic (low income
Findings from Community
Input Activities
population), or comprehensive health center or other health facility shortages.
Of the patients with encounters at Memorial Hospital of Carbondale during 2011, 19% were insured
by Medicaid, 16% by Medicare, 3% were dual-eligible, 3% had private-direct insurance, 31% were
private-employer self-insured, and 28% were uninsured. During SFY 2011, there were 62,850
Medicaid recipients in the MHC Service Area, representing one-quarter of the area’s total population.
Fifty percent of the area Medicaid recipients were children.
H e a lt h y C o m m u n i t y C o a l i t i o n s
SIH staff actively participates in local Healthy Community Coalitions, grassroots organizations whose
members foster collaboration and leverage their collective resources to improve the overall health
and well-being of Southern Illinois residents.
The priority work areas identified by the Jackson County Healthy Community Coalition (JCHCC) include
Illinois Department of Healthcare and Family Services
Number of Persons Enrolled in the Medical Program by County
sexual health, access to care, family violence, healthy living, behavioral health, and positive youth
development. The Franklin-Williamson Healthy Community Coalition has chosen to form action teams
County
Child
Disabled
Adults
Franklin
6,007
1,427
3,601
735
11,770
454
12,224
Jackson
6,823
1,493
3,743
639
12,698
600
13,298
Johnson
951
219
526
167
1,863
43
1,906
Perry
2,419
515
1,385
259
4,578
167
4,745
Saline
3,948
1,156
2,118
609
7,831
275
8,106
Union
2,571
932
1,450
438
5,391
263
5,654
Williamson
8,700
1,695
5,089
870
16,354
563
16,917
Total for MHC
Service Area
31,419
7,437
17,912
3,717
60,485
2,365
62,850
Other
Adults
Seniors
Total
Comprehensive
Total
Partial
Total All
Recipients
Source http://www2.illinois.gov/hfs/agency/Program%20Enrollment/Pages/default.aspx.
addressing Healthy Seniors, Healthy Lifestyles (physical activity and nutrition), and Access to care.
H e a l t h y SI De l t a Ne t w o r k ( H SIDN )
The Healthy Southern Illinois Delta Network is a forum
of community partners representing the southernmost
16 counties of Illinois, who have improving the health
status of community members throughout the region
as their mission. Rather than focus on individual health
behaviors, the network steering committee has chosen
to focus on policies, systems, and environmental
changes to support improvement in health and
increase sustainability. Their identified areas for focus
Ambulatory Care Sensitive Conditions (ACS) are primary care treatable conditions for which good
include smoke-free housing and smoke-free places,
patient education and adherence, outpatient care and monitoring can potentially prevent the need
coordinated school health, and worksite wellness, and
for hospitalization. A review of Memorial Hospital of Carbondale’s utilization (both inpatient and
joint use agreements.
emergency department), shows that use for ACS conditions is elevated in our area. It is likely that
these ACS utilization rates are due to differences in access and/or quality as well as poorer underlying
Community Input Survey
health status (disease prevalence) in the community.
In the fall of 2012, community members were provided with the opportunity to voice their opinions
about the public health needs and priorities in their own community through a brief email survey.
A convenience sample of participants was identified through discussion with county-wide Healthy
Community Coalitions, Health Leader’s Forum Steering Committee members, SIH Community
Benefits Department leadership and staff, as well as existing community contacts (i.e., college/
university faculty and students, parent booster clubs, local youth, service clubs, sports contacts,
neighbors, etc.) An invitation email with a SurveyMonkey link was sent to seventy individuals with a
follow-up reminder request sent one week later. The responses were collected anonymously.
| 29
Participants were asked to rank the top health issues and key social,
economic and environmental factors impacting health in our community.
the most votes were retained. The Round 1 Tally included mental health, access to specialty care,
cardiovascular health, adult dental health, alcohol abuse, childhood obesity, children’s dental health,
diabetes, and sexually transmitted diseases.
1. What do you think are the Top 5 Health Issues in your community?
2. What factors do you think most adversely affect our community?
3. Which factors most greatly impact the HEALTH of those living in your community?
4.In your opinion, what should be the priority health issues for ACTION?
Based on participant feedback, generic categories
for chronic disease and infectious disease were
Rank
removed, two groups were combined: Alcohol/Drugs
Topic
1
and Adult/Child Dental. A separate Smoking/Tobacco
Mental health
2
Adult/Child Dental
3
Childhood Obesity
4
Alcohol/Drug Abuse
5
Cardiovascular Health
topic was added, and Suicide was listed separately
The comments received were consistent with findings in the Community Health Profile and other primary
data collected. The “Top 5 Health Issues” in the community were identified as: Economy (poverty),
addiction, cardiovascular disease, pulmonary lung disease, and diet-related diseases/food choices.
Patient Health Priorities
from Mental Health. A second round of voting was
conducted with each participant then selecting
their top three priorities. The final rankings from the
external advisory team are listed to the right.
Factors identified as most adversely affecting our community were: access to mental health services,
I nt e r n a l A dvi s o ry
Te a m Mee t i n g
access to oral health services, cancer care, cardiovascular/heart disease, child & adolescent health
issues, chronic disease management, and emergency department use.
A process similar to what was used with the
Priorities for actions were summed up with the following
external team was followed with the Internal
comment: “Child and adolescent health issues should be
Advisory Team. The group was convened and
first on an agenda. With the economy hurting these are the
presented with the health data profile and
ones that suffer the most along with seniors. I see people
initial key findings for the SIH Service area.
having to make a choice of health or food. Unfortunately you
The revised list of topics from the external
cannot control the economy, but to step in and take action
group was used for multi-round voting. SIH
where children and Senior Citizens have a chance to get
Community Benefits staff provided a set of
proper care may be [the best] option.”
criteria by which to consider the topics. The
group considered 1) how much the issue
Focus groups
One Strong Survivors Cancer Recovery Group participated in a focus group as part of the SIH CHNA
process. The focus group was conducted by SIH Community Benefit Department staff following a
semi-structured format. Key items expressed during the discussion included: transportation was
a small issue, support groups were invaluable, more caregiver/family support is needed, seniors
need more services, need better communication/link up to available services. For example, one
survivor said, “If I had known it [care] was available I wouldn’t have had to leave the area.” Several
suggestions were made and will be incorporated during the action planning implementation phase of
the CHNA process.
affects health and quality life in our community, and/or contributes to multiple health-related issues
(overall impact); 2) how many lives are affected in our
community, and how does our community compare
Patient Health Priorities
to national benchmarks and goals (magnitude of the
Rank
problem); the degree to which the issue leads to pre-
Topic
1
Mental health
2
Obesity
3
Access to health care
3
Transportation
mature morbidity and mortality (severity); 4) and the
ability and interest of the community to effectively
address the issue.
Participants again chose their top five priorities on the
first round, and their top three priorities on the second round. A write-in option was also available.
E x t e r n a l A d v i s o r y Te a m Mee t i n g
Following data collection, the external advisory team was convened to review the findings and
The Round 1 Tally included seven priority topics: access to health care, mental health, transportation,
chronic obstructive pulmonary disease, diabetes, education and obesity.
provide input on health priorities for the SIH primary service area. SIH Community Benefits
The final rankings from the Internal Advisory Team are listed to the right.Additional community
Department staff generated an initial topic list and facilitated a multi-round ranking/voting activity.
priorities were identified through local health departments’ Illinois Project for Local Assessment of
Participants were also allowed a write-in vote if they believed something was missing that should
Needs (IPLAN).
be represented. Participants were instructed to select which they perceived to be the top five
priorities. After discussion and suggestions for combining and modifying topics, nine items receiving
| 31
S umma ry
In summary, the primary and secondary community health data collected across a range of indicators
show that multiple determinants of health are affecting the health status of our community in the
MHC service area. Priority areas for focus were identified under five general categories based on the
data findings. The SIH Community Benefits Department will incorporate the priority areas, gaps and
resource analysis into action planning and implementation phases.
Delta-region (16 counties) IPLAN Priorities Identified
Hamilton
Jackson
Randolph
Bi-County
County
Egyptian
Southern 7
Perry County County
County
Health Dept. Health Dept. Health Dept. Health Dept. Health Dept. Health Dept. Health Dept.
(2010-2015)
(2011-2015)
(2010-2015)
(2008-2013)
(2013-2017)
(2013-2017)
(2010-2015)
Hamilton
Gallatin,
Alexander,
Randolph
Franklin &
Perry
Jackson
Saline &
Hardin,
White
Johnson,
Williamson
Massac,
Pope, Pulaski,
& Union
Cardiovascular Substance
Heart
Family
Access to
Diseases of
Cardiovascular
Disease
Abuse
Disease
Services
Care
the heart
Disease
Cancer
Heart
Obesity &
School
Chronic
Coronary
Oral Health
Disease
Type II
Health
Disease
Heart
Care Access
& Stroke
Diabetes
Obesity
Cancer
Obesity
Disease
Immunizations Behavioral
Health
Malignant
Sexually
Neoplasm
Transmitted
Infections
Cancer
(Chlamydia &
gonorrhea)
Mission
We are dedicated to improving the health
and well-being of all of the people in the
communities we serve.
Values
Respect
Recognizing and valuing the dignity and uniqueness of each person
Integrity
Adhering to strong moral and ethical principles in all we do
Compassion
Responding to the feelings and needs of each person
with kindness, concern and empathy
Collaboration
Communicating and working with others for the benefit of all
Stewardship
Responsibly using, preserving and enhancing our human and material
resources as a not for profit community controlled organization
ACCOUNTABILITY
Holding ourselves and those around us responsible for living the Values and
achieving the Vision of Southern Illinois Healthcare
Quality
Striving for excellence in all we do
Community Health Profile
Appendix 1
To
2012 Community Health Needs Assessment
1|Page
Steering Committee
External Advisory Team
Dr. Ted Grace – Director, SIU Student Health Center
Robin Koehl – Director, Franklin-Williamson Bi-county Health Department
Toni Kay Wright – Health/Nutrition Coordinator, SIUC Head Start
Miriam Link-Mullison – Director, Jackson County Health Department
Kathy Renfro – Executive Director, Carbondale Park District
Jodi Schoen – Director, Perry County Health Department
Patsy Jensen – Executive Director, Shawnee Health Services
Karen Frietag – Chief Administrative Officer, H Group
Deborah Pape – H Group
Greg Stettler – Director of Continuing Education, John A. Logan College
Kurt Endebrock – Assistant Regional Superintendent, Franklin/Williamson Regional Office of Education
Dr. Quincy Scott – Director, Southern Illinois University Family Medicine, SIU School of Medicine
Kim Sanders – Director, Center for Rural Health and Social Service Development (CHRSSD)
Donna Boros- Regional Superintendent, Jackson/Perry Regional Office of Education
Internal Advisory Team
Kelly Pool – Case Management, Herrin Hospital
Heather Ruhe – Bariatric Program Coordinator, Herrin Hospital – New Life Weight Loss Center
Mary Williams – Quality & Risk Manager, Southern Illinois Medical Services
Cathy Blythe –System Planning Manager
Woody Thorne – Vice President, Community Affairs
Ginger Hilliard – Business Development Manager, Ambulatory & Physician Services
Dr. Joseph Haake – Emergency Department Physician, Memorial Hospital of Carbondale
Shelly Pierce – Senior Corporate Director, Patient Relations
Amy Niemann – Employee Health, Wellness & Benefits System Manger
Lynn Bree – Director, Corporate Clinical Services
Amy Wright – Community Benefits Manager
Diane Land – Community Health Coordinator
Jo Sanders – Health Ministry Coordinator
Heather Troester – School Health Coordinator
Scott Seaborn – Administrator, St. Joseph Memorial Hospital
Terence Farrell – Administrator, Herrin Hospital
2|Page
Table of Contents
Steering Committee ............................................................................................................ 2
Executive Summary............................................................................................................. 4
SIH Primary Service Area..................................................................................................... 5
Demographics ..................................................................................................................... 5
Socioeconomic Factors ....................................................................................................... 9
Health Status and Outcomes ............................................................................................ 15
Health Behaviors ............................................................................................................... 21
Systems and Access to Care .............................................................................................. 24
Barriers to Medical Care ................................................................................................... 32
Quality and Effectiveness of Care ..................................................................................... 35
Cancer Health.................................................................................................................... 37
Cardiovascular Health ....................................................................................................... 37
Chronic Obstructive Pulmonary Disease .......................................................................... 40
Diabetes Health................................................................................................................. 40
Risk Behaviors ................................................................................................................... 41
Physical Environment........................................................................................................ 42
List of Indicators ................................................................................................................ 44
3|Page
Executive Summary
During 2012, Southern Illinois Healthcare (SIH) along with a diverse group of community
partners conducted a Community Health Needs Assessment (CHNA) designed to
spotlight health and quality of life issues in the communities served by SIH facilities. This
systematic process helped identify issues where changes in the healthcare delivery
system and continued collaboration could improve patient care, preventive services,
and overall health and quality of life.
The CHNA was conducted as part of Southern Illinois Healthcare’s Community Benefits
planning process. The goal was to identify the most important health issues in the SIH
service area, particularly for vulnerable and under-represented populations, to ensure
that programs and services closely match the priorities and needs of the community,
and to strategically address those needs to improve the health of the communities
served by SIH facilities.
In addition, this report has been prepared in anticipation of IRS Notice 2011-52 relating
to community health needs assessment ("CHNA") required by Internal Revenue Code
("Code") Section 501(r)(3). It includes:
1. A description of the community served by Southern Illinois Healthcare
2. A description of the process and methods used (including data sources and
timeframes used in the assessment, and analytical methods applied to identify
community health needs).
3. An account of how the broad interests of the community served were obtained
and incorporated into the assessment.
4. A prioritized description of the health needs identified
5. A description of existing health care facilities and other resources available to
meet the community health needs identified through the CHNA.
How to Use this Report
The Health System Profile Report presents compiled health indicators, data sources and
a summary of identified priority areas for the SIH primary service area. Findings and
implementation plans specific to each hospital are presented in the companion
documents – Community Health Needs Assessment Report. Each CHNA Report provides
background, an overview of the assessment, key findings, and presents the information
gathered during the community input process. Priority health issues and needs are
4|Page
highlighted to provide information and garner support from those in the community
who may want to support or otherwise become involved. Joining strengths and
leveraging resources in such local efforts, will increase our community capacity,
supporting successful and sustainable improvements in health and quality of life.
Our Community – SIH Primary Service Area
Most of our
patients live
in these
cities:
SIH 7-County Primary Service Area
Carbondale (62901)
Murphysboro
Marion
Carterville
DuQuoin
Anna
Herrin
Carbondale (62902)
West Frankfort
Desoto
Cobden
Benton
Carbondale (62903)
Makanda
Pinckneyville
Elkville
Jonesboro
Johnston City
Harrisburg
Ava
Goreville
Dongola
Christopher
Eldorado
Chester
Tamaroa
Vienna
Royalton
*descending order by volume
Demographics
Rural profile
The community served by SIH includes rural and very rural areas largely separated by
the Shawnee National Forrest and farmland. While formerly dispersed, the region is becoming
more centralized around the “Route 13 Corridor” and the city of Carbondale.
Geography QuickFacts
Land area in square miles,
2010
Persons per square mile,
2010
Illinois
Jackson
Franklin Williamson
55,518.93
584.08
408.89
231.1
103.1
96.8
Perry
420.15 441.76
157.9
50.6
Johnson
Union
Saline
343.92 413.46 379.82
36.6
43.1
65.6
5|Page
Economy
The local economy is heavily dependent on educational services, health care and social
assistance (42.1%); arts, entertainment, recreation, accommodations and food service (15.1%);
retail trade (12.6%); public administration (5.0%), and other services industries making up the
remainder.
Major employers (500+ employees) in the area include: Southern Illinois Healthcare, The
H Group, Southern Illinois University Carbondale, John A. Logan Community College, Center for
Medical Arts, AISIN Manufacturing, Inc., Blue Cross Blue Shield, Primex Corporation, Heartland
Regional Medical Center, Veteran’s Administration, COM-PAC International, Center for
Comprehensive Services, Bombadier of America , Pepsi Mid-America, and state and county
governments.
Population
Memorial Hospital of Carbondale and Herrin Hospital are
situated in the most densely populated area in Southern Illinois.
The Carbondale-Marion-Herrin Illinois Combined Statistical
Area, a two county stretch, is home to approximately 125,000
residents. With the addition of the communities served primarily by St. Joseph
Memorial Hospital in Murphysboro, the seven counties included in the overall SIH
primary service area are Jackson, Franklin, Williamson, Perry, Johnson, Union, and
Saline. These seven counties are home to an estimated 243,789 people. Collectively
the region experienced a small increase total population between 2000 and 2010.
Population Trends 7-County Area
500,000
450,000
400,000
350,000
300,000
250,000
238,812
236,048
240,924
243,789
1980
1990
2000
2010
200,000
150,000
100,000
50,000
6|Page
While the majority (12 out of the southernmost 17) Southern Illinois counties saw a
population decline in the last 10 years, five counties did have population increases. Three of
those five counties experiencing a growth in population (Jackson, Williamson, Franklin, Massac
and Pope) are within the SIH service area.
10.0
% Population Change
6.0
4.0
8.3
2000-2010
8.0
3.3
1.4
2.0
1.0
0.0
-2.0
-4.0
-3.2
-2.7
-2.3
-6.0
-6.8
-8.0
2010 Census Population Compared to 2000: Illinois Counties
1
Location
2000 Census
Total Population
Illinois
2010 Census
Total Population
2000-2010
Change
2000-2010
% Change
12,419,293
12,830,632
411,339
3.3
Franklin
39,018
39,561
543
1.4
Jackson
59,612
60,218
606
1.0
Johnson
12,878
12,582
-296
-2.3
Perry
23,094
22,350
-744
-3.2
Saline
26,733
24,913
-1,820
-6.8
Union
18,293
17,808
-485
-2.7
Williamson
61,296
66,357
5,061
8.3
240,924
243,789
2,865
1.2
Total
Source: U.S. Census Bureau, 2010 Census. 2010 Census Redistricting Data (Public Law 94-171) Summary File, Tables P1 and H1
7|Page
Age profile
The median age in Illinois (2010) was 36.6 years of age and the U.S. as a whole was 37.2.
With the exception of Jackson County, the median age in our area is slightly higher. The average
percentage of population age 65+ in Illinois overall is 12.7%. Again, with the exception of
Jackson county, these Southern Illinois counties have a higher percentage of adults age 65 years
and older than the state average. Having a larger percentage of older adults has implications
for service delivery and demand for healthcare services.
Age Profile
Illinois
Median age (years)
Franklin
Jackson
Johnson
Perry
Saline
Union
Williamson
36.6
41.8
29.1
42.2
39.4
41.7
42.9
40.1
% Under age 5
6.4%
6.0%
5.1%
4.4%
5.1%
5.9%
5.6%
6.0%
% Under age 18
24.1%
22.7%
17.3%
18.8%
20.5%
22.8%
21.3%
22.0%
% Age 65+
12.7%
18.3%
11.8%
17.6%
15.9%
18.5%
18.5%
16.5%
Gender Ratio
The following chart includes the gender ratio for each of the seven counties in our
primary service area. Johnson and Perry counties have a higher proportion of male residents.
The remaining counties are fairly equally distributed.
Gender Ratio
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
Franklin
Jackson
Johnson
Perry
Saline
Union
Williamson
Male
48.9%
50.9%
55.8%
54.2%
48.8%
49.9%
49.5%
Female
51.1%
49.1%
44.2%
45.8%
51.2%
50.1%
50.5%
8|Page
Racial and Ethnic Composition
The following table provides race/ethnicity demographics from the 2010 Census for the
counties of Franklin, Jackson, Johnson, Perry, Saline, Union, and Williamson in Illinois. The area
is predominantly White. Jackson County has a higher percentage of Black, Asian/Pacific
Islanders, American Indian/Alaska Native, and Hispanic residents than the other counties.
Race and Ethnicity, 2010
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Franklin
Jackson
Johnson
Perry
Saline
Union
Williamso
n
Hispanic
1.4%
4.3%
3.1%
2.8%
1.6%
5.1%
2.0%
White
97.7%
78.5%
89.9%
88.9%
93.0%
96.4%
92.9%
Black
0.5%
14.7%
8.5%
8.8%
4.3%
1.1%
4.2%
Asian/Pacific Islander
0.4%
3.7%
0.2%
0.4%
0.5%
0.4%
0.9%
Amer. Indian/Alaska Native
0.3%
0.5%
0.4%
0.4%
0.4%
0.7%
0.4%
Socioeconomic Factors
Educational Attainment
In the seven-county SIH service area, overall, 83% of the population has at least a high school
diploma. Approximately 18% over age 25, have a bachelors degree or higher. Poverty rates, unemployment
rates, and lower health status have been linked to low levels of educational attainment among adults. In all
except Jackson County, less than a quarter of the population over 25, have college degrees.
High school graduates, percent of
persons age 25+, 2006-2010
100%
80%
60%
40%
20%
0%
Bachelor's degree or
higher, percent of persons age
100%
25+, 2006-2010
80%
60%
40%
20%
0%
9|Page
High School Graduation Gaps
Good education predicts good health. Academic achievement and disparities in health, future
employment and earnings potential are closely linked. According to the Illinois State Board of
Education School Report Cards, 82.3% of Illinois students graduated from high school with a
regular diploma in four years in 2012 (down from 86% in 2011). The majority of high schools in
the SIH primary service area have graduation rates below statewide levels and have racial
achievement gaps consistent with state comparisons.
Illinois High School Graduation Rates,
by race/ethnicity (2011-2012)
Illinois' Graduation in 4-Years
100%
82%
80%
No
18%
93%
89%
76%
79%
83%
68%
All Students
White
60%
Black
Hispanic
40%
Yes
82%
Asian
American Indian
20%
Multi-racial
0%
Comparison of Local High Schools’ 4-year Graduation Rates
School
Carbondale Comm. HS
All
Students
82.9
Murphysboro HS
Trico Senior HS
Benton Consol. HS
Marion HS
Johnston City HS
Herrin HS
Carterville HS
Pinckneyville HS
DuQuoin HS
Anna-Jonesboro HS
Harrisburg Comm. HS
Eldorado HS
Goreville HS
Vienna HS
70.0
96.8
80.9
85.9
77.6
71.6
83.3
81.7
86.3
84.2
78.1
72
91.1
71.7
White
Black
Hispanic
Asian
American
Indian
Multiracial
87.7
73.9
92.9
84.6
55.6
70.5
96.7
80.4
86
82.3
74.4
82.9
82.3
86.0
84.2
76.9
74.4
90.9
71.2
66.7
75
100
100
85.7
100
33.3
100
0.0
100
100
85.3
0
50
66.7
85.7
80
44.4
0
100
80
100
33.3
100
100
100
50
100
100
14.3
55.6
100
50
100
100
100
100
50
66.7
100
100
100
100
100
100
55.2
Note: This chart displays the overall percentage by school and race. Actual counts are suppressed due to small numerators in some instances.
10 | P a g e
Income
The annual median family income for the seven-county service area is lower that state
and national levels. The median household income ranges from a low of $32,169 in Jackson
county to a high of $41,619 in Johnson County (Illinois’ is $55,735, U.S. is $51,914).
Median Household Income (2006-2010)
$100,000
$90,000
$80,000
$70,000
Illinois, $55,735
$60,000
$50,000
$40,000
$40,579
$32,169
$34,381
Jackson
Franklin Williamson
$40,696
$41,619
Perry
Johnson
$39,760
U.S., $51,914
$35,644
$30,000
$20,000
$10,000
$0
Union
Saline
People Living Below Poverty Level
30%
25%
20%
15%
U.S., 13.8%
Illinois, 12.6%
10%
5%
0%
Jackson
Franklin
Williamson
Perry
Johnson
Union
Saline
11 | P a g e
Children living in poverty are more likely to have physical, behavioral, and emotional
health problems. It has been shown that children living in poverty have lower achievement test
scores, and are less likely to graduate from high school (affecting their future employment
opportunities and earning potential).
Children Living Below Poverty Level
50%
45%
40%
35%
32.1%
30%
30.5%
26.5%
24.3%
25%
22.6%
20%
19.0%
22.6%
15%
10%
5%
0%
Jackson
Franklin
Williamson
Perry
Johnson
Union
Saline
Unemployment
High unemployment has personal and societal impacts, affecting access to health care,
straining financial and emotional support systems, and contributes to decreased quality of life.
Location
Unemployment
Rate
Jackson
8.8
Franklin
11.1
Williamson
8.8
Perry
11.6
Johnson
10.7
Union
11.4
Saline
9.6
Local area unemployment ranges from 8.8% in Jackson and
Williamson counties to around 11% in Franklin, Perry, Union, and
Johnson counties. The SIH service area has a higher
unemployment rate that the state and national averages.
The U.S. Bureau of Labor Statistics reported that the national
unemployment rate in September 2012, decreased to 7.8
percent. The overall unemployment rate (seasonally adjusted)
for Illinois was 8.8 percent.
Source: Bureau of Labor Statistics, June 2012; October
2012
12 | P a g e
Food Assistance
Indicators that may reflect food
insecurity include Supplemental Nutrition
Assistance Program (SNAP) participation,
Women’s Infants and Children, and Children
Eligible for free and reduced-price lunch
programs.
In the U.S., one in eight adults and
one in four children were using SNAP
benefits as of 2009. Each county in the
primary service area has a significantly
higher percentage of the population
meeting the federal poverty guidelines and
participating in SNAP.
Students Eligible for Free Lunch
Program
Comparison: 3,130 U.S. Counties and county equivalents
Location
percent
Franklin
47.2
Jackson
47.0
Perry
37.6
Williamson
37.5
Johnson
37.8
Union
44.6
Saline
44.0
Status
Source: U.S. Department of Agriculture - Food Environment Atlas,
2009; http://www.ers.usda.gov/FoodAtlas/downloadData.htm
Percent of Low-Income Persons who are SNAP Participants
60.0%
50.0%
40.0%
49.6%
47.0%
44.2%
42.6%
38.5%
34.8%
40.9%
30.0%
20.0%
10.0%
0.0%
Franklin
Jackson
Perry
Williamson
Johnson
Union
Saline
Source: U.S. Department of Agriculture - Food Environment Atlas, 2007; http://www.ers.usda.gov/FoodAtlas/downloadData.htm
13 | P a g e
The number of single-parent households, the degree to which residents of a community
feel they have adequate social and emotional support, and the safety of a community are
additional indicators of quality of life and health. Single-parent families have an increased
likelihood of poverty, may lack access to affordable, high-quality child care and after-school
programs – in turn increasing the number of at-risk kids in a community. A safe environment,
including safe-housing and public spaces free from danger and hazards is important for a
healthy community.
Family/Social Support
Percentage
with “No
Location
SocialEmotional
Support”
Community Safety
Percentage
Single-Parent
Households
Location
Violent Crime Rate/100,000
Illinois
21%
31%
Illinois
532
Franklin
Jackson
Johnson
18%
21%
-
42%
706
-
34%
-
34%
-
31%
33%
Franklin
Jackson
Johnson
Perry
Saline
Union
Williamson
Perry
Saline
Union
Williamson
15%
Source: Illinois BRFSS, 2009
40%
15%
652
546
258
451
149
446
14 | P a g e
Health Status and Outcomes
County Health Rankings
County Health Rankings are a way to measure and understand how healthy
communities served by SIH facilities are. Each county’s rank is determined by assessing health
behaviors, access to and quality of clinical care, social and economic influences such as crime
and education levels, and the physical environment. Actual health outcomes such as causes of
death, and quality and length of life are measured along with the other counties in the state to
draw comparisons. High ranks (e.g., 1 or 2) are estimated to be the ‘healthiest’ areas. In
general, a poor ranking on health factors translates to poor health outcomes. The SIH service
area posts some of the lowest ranks out of the 102 Illinois counties.
County Health Rankings 2012: Illinois (102 counties)
County
Franklin
Jackson
Johnson
Perry
Saline
Union
Williamson
Health Outcome
Rank
97
80
64
69
98
53
93
Health Factor
Rank
94
41
73
85
69
76
60
Source: University of Wisconsin Population Health Institute. County Health Rankings, 2012.
15 | P a g e
Health Status
Health status is an important indicator of quality of life and a factor that drives the
demand for health care services. Most of the residents in the seven-county service area
consider their general health to be excellent/very good or good/fair. Over half say they have
had no days in the last year when their physical health was not good.
GENERAL HEALTH STATUS
poor
7%
good/fair
45%
DAYS PHYSICAL HEALTH
NOT GOOD
8-30
excellent/
very good
48%
How is your general health?
Location
Excellent/Very good
Nationwide (States & DC)
56.0%
Illinois
55.1%
7-County Service Area
48%
1-7
days
none
Good/Fair
40.4%
41.1%
45%
Poor
3.7%
3.8%
7%
About one in five people in the service
area say that they have had between 8-30
days in the last year when their mental health
was not good. Another one in five people say
they have had at least one day, and up to one
week in the last year when their mental
health was not good.
DAYS MENTAL HEALTH NOT
GOOD
8-30 days
21%
1-7 days
21%
none
58%
16 | P a g e
Low Birth Weight
Low birth weight is an important indicator of
a community’s health status. It is a major
determinant of mortality, morbidity and
disability in infancy and childhood, as well as
impacting long-term health in adults.
Franklin, Saline and Williamson counties, are
in the 25th to 50th percentile (yellow on the
status indicator). Johnson, Perry and Union
counties have higher percentages of low
birth-weight babies when compared to the
102 Illinois counties and are indicated in red
which represents the "worst" quartile. The
most important causes of low birth weight
infants include the nutrition of the mother,
her age, whether or not prenatal care was
used, and whether or not the mother smokes.
Babies with Low Birth Weight
(<2500 grams) Comparison: IL Counties
Location
Percent
Status
Franklin
8.8
Jackson
7.7
Johnson
10.6
Perry
9.6
Saline
8.4
Union
9.8
Williamson
5.9
Source: IDPH, Health Statistics, 2009
Life Expectancy
Years of Potential Life Lost (YPLL) is one measure to estimate premature death. YPLL
calculates the difference between the current life expectancy age (75 years old) and the age at
time of death for those who died prior to reaching that age.
Years of potential life lost before age 75 per 100,000 population (age-adjusted) focused
on premature mortality rather than overall mortality drawing attention to deaths that could
have been prevented. Examining YPLL and underlying causes for the community, helps target
resources toward strategies that will extend years of life.
17 | P a g e
Years Potential Life Lost, 2006-2008
12,000
10,986
10,840
9,507
10,000
8,243
8,000
8,110
8,002
Years of
potential life
lost before age
75 per 100,000
population
(age-adjusted)
7,743
6,728
6,000
4,000
2,000
0
Source: http://www.countyhealthrankings.org/#app/illinois/2012/measures/outcomes/1/data
Leading causes of death
The majority of leading causes of
death in 2009 retained rankings similar to
those in 2008. Examining disease indicators
for our community shows that in general, the
leading causes of death are consistent with
Illinois’ and national trends.
It is clear that many of the leading
causes of death can be attributed to a core
group of preventable causes including:
Alcohol, tobacco, and other drug use, physical
inactivity, poor nutrition, environmental
influences, preventable injuries, and mental
health.
Causes of Death (7-County Service Area)
Cancer, 24.6%
Chronic lower
respiratory
diseases , 7.1%
Heart
Disease, 25.5%
Stroke, 5.6%
All other
causes, 12.5%
Accidents
(unintentional
injuries), 4.8%
Alzheimer’s
Disease, 5.8%
Chronic liver
disease, 1.2%
Suicide, 1.3%
Influenza &
Pneumonia,
2.
Septicemia, 1.8
6%
%
Diabetes
Mellitus, 3.2%
Nephritis/Kidn
ey
disease, 4.0%
Source: IDPH Health Statistics,
http://www.idph.state.il.us/health/bdmd/deathcauses_09.htm
18 | P a g e
Health Outcomes (Mortality Rates)
Age-Adjusted Death Rate due to
Colorectal Cancer (CRC)
Age-Adjusted Death Rate due to
Breast Cancer
Comparison: U.S. Counties
Location
Status
Franklin
deaths/100,000
population
20.0
Location
Status
Franklin
deaths/100,000
females
28.9
Jackson
19.8
Jackson
27.4
Perry
19.9
Perry
25.1
Williamson
20.1
Williamson
22.2
Johnson
28.0
Johnson
* 3 or fewer
Union
19.4
Union
25.7
Saline
21.5
Saline
29.7
Source: National Cancer Institute (2005-2009) http://statecancerprofiles.cancer.gov/deathrates/deathrates.html
Diseases of the heart
Mortality rates 2007
Cerebrovascular diseases
Mortality rates 2007
Comparison, US 186.5/100,000
Location
Count
Ageadjusted
Rate*
Illinois
25,766
173.2
Location
Count
Ageadjusted
Rate*
Illinois
5,851
39.7
Franklin
113
213.1
Franklin
21
39.2
Jackson
134
253.6
Jackson
22
41.2
Johnson
37
244.7
Johnson
***
***
Perry
46
169.3
Perry
14
51.2
Saline
102
277.4
Saline
30
81.6
Union
55
228.4
Union
12
48.4
190
233.1
Williamson
41
49.7
Williamson
19 | P a g e
Diabetes-Related Mortality 2007
COPD Mortality Rates 2007
Location
Count
Ageadjusted
Rate*
Illinois
2,850
19
Franklin
30
55.5
(Chronic lower respiratory diseases)
Comparison, US 44/100,000
Location
Count
Ageadjusted
Rate*
Illinois
4,731
32.1
Jackson
16
30.1
Franklin
40
73.9
Johnson
***
***
Jackson
16
30.5
Perry
***
***
Johnson
13
86.2
Saline
***
***
Perry
20
74.6
Union
***
***
Saline
15
40.6
16
20.1
Union
***
***
48
57.6
Williamson
Williamson
Deaths by Accidents (unintentional),
2007
Influenza and pneumonia 2007
4,319
Ageadjusted
Rate*
28
Franklin
28
72.5
Location
Count
Ageadjusted
Rate*
Illinois
2,549
17.3
Jackson
27
49.1
Franklin
12
21.9
Johnson
***
***
Jackson
***
***
Perry
20
83.6
Johnson
***
***
Saline
20
75.8
Perry
***
***
Union
***
***
Saline
13
34.1
48
71
Union
***
***
20
24.6
Location
Illinois
Williamson
Count
Williamson
Motor Vehicle Accidents (Fatal)
2009-2010
Location
Count
Ageadjusted
Rate*
Illinois
2,026
6.4
Franklin
0
0
Jackson
***
***
Johnson
0
0
Perry
***
***
Saline
0
0
Union
0
0
***
***
Williamson
Source: IQuery, Illinois Department of Public Health,2006-2008;
Illinois data from IDPH and national data from NCHS Vital
Statistics System;
http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_10.pdf and
www.statehealthfacts.org/
* Age-adjusted rates per 100,000 U.S. standard population (based
on the 2000 census estimated as of July 1, 2008)
*** Rate is suppressed due to a small numerator and to ensure
confidentiality and meaningful data.
20 | P a g e
Health Behaviors
Alcohol Consumption
Alcohol abuse is associated with a variety of negative health and safety outcomes. The
percent of adults in our community who reported binge drinking (at least once in the previous
30 days) has increased in every county when comparing 2004-2006 to 2007-2009. Binge
drinking is defined as five or more drinks on one occasion for males (four drinks for females).
Percentage of Adults who Binge Drink (Time Series)
Jackson
Saline
2004-2006
22.6
2007-2009
2004-2006
23.5
0
5
10
15
20
25
8
2007-2009
30
12.7
0
Franklin
2004-2006
2004-2006
2007-2009
25.7
5
10
15
20
25
5
10
15
25
30
20.6
5
10
15
20
25
30
25
30
Williamson
2004-2006
13.3
0
20
12.9
0
30
11.1
2007-2009
15
2007-2009
Johnson
2004-2006
10
Union
15.2
0
5
12.6
2007-2009
20
25
30
17.1
0
5
10
15
20
Source: BRFSS, 2004-2009
Perry
2004-2006
18.5
2007-2009
23.4
0
5
10 15 20 25
30
21 | P a g e
Smoking
Tobacco is a large contributor to avoidable illness, disability, and death. In addition
to direct smoking exposure, communities with a high smoking prevalence have greater
exposure to secondhand smoke for non-smokers with the potential to cause or contribute to
a wide range of negative health effects, including cancer, respiratory infections, and asthma.
Approximately one-third of all tobacco users in this country will die prematurely because of
their dependence on tobacco.
At least one in five adults in the primary service area smoke. Four of the seven counties
have remained at the same level from 2007-2009 measurements. Johnson and Saline counties
have seen slight decreases in smoking rates. The percentage of adults who smoke in Union
county is increasing.
Adults who Smoke
Comparison: Prior Value
Location
percent
Status
Franklin
28.3
Jackson
25.8
Perry
24.0
Williamson
27.4
Johnson
21.7
Union
27.7
Saline
20.4
Source: Illinois Behavioral Risk Factor Surveillance System, 2007-2009
Preventive Care
Preventive care includes behavioral lifestyle choices, education, and clinical preventive
services such as screenings, counseling services, family and pediatric medicine, and behavioral
health that aim to improve the health of people by keeping them from getting sick in the first
place (to prevent the onset of disease).
22 | P a g e
Immunizations
Percent of adults with Influenza
vaccination in last 12 months
Location
Percent of adults who ever had
a pneumonia vaccination
Franklin
34.0
25.1
Jackson
35.5
31.7
Perry
33.2
28.8
Williamson
44.8
34.7
Johnson
27.0
27.9
Saline
48.9
36.6
Union
45.3
30.5
Breast Cancer Screening/Mammogram
History (women 40 and older)
Colon Cancer Screening
percent
Location
Franklin
Location
Status
89.5
Franklin
Status
percent
67.2
Jackson
95.7
Jackson
60.9
Perry
86.1
Perry
50.0
Williamson
92.7
Williamson
70.7
Johnson
93.2
Johnson
63.3
Union
85.2
Union
61.6
Saline
91.8
Saline
52.0
Preventive Care
100%
LAST ROUTINE CHECKUP 1 year or less
LAST ROUTINE CHECKUP More than 1 year/Never
90%
80%
70%
73%
73%
60%
70%
58%
50%
40%
42%
30%
20%
73%
68%
66%
34%
28%
27%
32%
27%
30%
10%
0%
Jackson
Franklin
Williamson
Perry
Johnson
Union
Saline
23 | P a g e
Systems and Access to Care
Medically Underserved
Medically underserved areas
(MUAs) are a state level
designation indicating areas having
too few primary care providers,
high infant mortality, high poverty
and/or high elderly population.
The Illinois Department of Public
Health Center for Rural Health has
identified the SIH service area as
having physician shortages. All
seven counties in the SIH primary
service area are in medically
underserved areas.
Location
MUA Population Designated Score
ID #
Franklin
County
55.6
00805
Jackson
County
45.7
00808
Johnson
County
57.0
00810
Perry
Beaucoup Precinct
61.1
05001
Cutler Precinct
51.7
05002
Saline
Low Income
56.6
07098
Union
County
58.2
00819
Williamson
Blairsville/Carterville Service Area
60.9
00865
Williamson Service Area
59.0
00866
Health Provider Shortage Area
Health Professional Shortage Areas (HPSAs) are designated at the federal level by the
Health Resources and Service Administration (HRSA). This means there is a known shortage of
primary medical care, dental or mental health providers. There may also be geographic (a
county or specific service area), demographic (such as low-income population), or a shortage of
public health facilities (institutional shortage) such as a comprehensive health center, federally
qualified health center or other public facility. HRSA has designated the entire counties of
Franklin, Johnson and Perry, and partial areas of Jackson, Saline, Union, and Williamson
counties based on low-income criteria.
HPSA
Franklin
Jackson
Johnson
Perry
Saline
Union
Williamson
State Designation
Entire County
Yes
No
X
X
X
X
X
X
X
Service Area
Medically Indigent
Egyptian Health Dept.- Eldorado
Federal Designation
Entire County
Yes
No
X
X
X
X
X
X
X
Service Area
Low income
Low income
Low income
Low income
Low income
Low income
Score
13
11
15
15
15
10
12
Source: http://muafind.hrsa.gov/; U.S. Department of Health and Human Services, Health Resources and Services Administration, Shortage
Designation Branch, http://hpsafind.hrsa.gov, 2012; http://www.idph.state.il.us/about/rural_health/ 2009.
24 | P a g e
Primary Care
Access to quality primary health care is integral for prevention, screening, early
diagnosis and treatment of medical conditions. Health insurance, household income level,
having a usual source of primary care (a medical home), and use of emergency rooms for
ambulatory care sensitive conditions are predictors of access to quality health care.
As a designated medically
underserved/health service provider
shortage area, there is a known
shortage of primary medical care,
dental and mental health providers.
When assessed regionally (7-county
service area), the average primary
care provider rate is 102 per 100,000
people or a ratio of 972 to 1. The
average number of primary care
providers in Illinois is 126 per 100,000
people or a ratio of 778 to 1. The
National Benchmark (90thpercentile) is
158 primary care providers per
100,000 people or a ratio of 631 to 1.
Primary Care Provider Rate
Location
providers/100,000
population
Status
What does this mean?
The number of people in each
county for every one primary
care provider is about:
Jackson
189
529 to 1
Franklin
81
1,228 to 1
Williamson
108
923 to 1
Perry
80
1,248 to 1
Johnson
15
6,838 to 1
Union
128
784 to 1
Saline
120
833 to1
Source: County Health Rankings (2009), comparison U.S. counties
25 | P a g e
Dental Health
Good oral/dental health is associated with improved health status. Those living in rural
communities and those in Health Provider Shortage Areas (HPSAs) however, experience frequent and
unresolved health problems. Often this is because they are not receiving timely and appropriate
(setting) dental services. Emergency department utilization data suggests that this is also the case for
the SIH service area.
An analysis of SIH Emergency
Department visits for fiscal year
2012, showed that for those visiting
the ED five or more times, “Dental
Disorders” were the 6th most
frequent reason for visits to the ED
by those with Medicaid, and 8th
most frequent reason for visit for
those with any payor source.
26 | P a g e
Mental Health
High volumes of Emergency Department utilization for both routine and crisis mental health
disorders suggest access or barriers to care.
SIH utilization patterns suggest
access/barriers to ambulatory,
outpatient and other less intensive
services or a failure to access
treatment for mental health until the
individual’s need has risen to a more
critical level. In either case, mental
health utilization rates need to be
viewed within the context of the
service systems and HPSAs in these
counties.
According to the CDC an
estimated eight to 25 attempted
suicides occur per every suicide
death.
Source: U.S. Department of Health and Human Services, Health Resources and Services Administration, Shortage Designation Branch,
http://hpsafind.hrsa.gov, 2012; http://www.idph.state.il.us/about/rural_health/ 2009.
Suicide Mortality Rates
Age-adjusted suicide deaths/100,000 population
16
14
Illinois,
8.6 per
100,000
12
10
8
6
4
2
0
Franklin
Jackson
Perry
Williamson Johnson*
Union
Saline
Source: Centers for Disease Control and Prevention, National Center for Health Statistics
*Rate flagged as “Unreliable” due to a numerator of 20 or less.
27 | P a g e
Percent of students who seriously considered attempting suicide
in the past 12 months
10th grade
Location
Franklin
Jackson
Perry*
Williamson
Johnson*
Union
Saline
12th grade
26%
19%
12%
18%
N/A
N/A
14%
16%
N/A
N/A
14%
N/A
Alternate question:
th
22% of 8 graders felt so sad or hopeless almost every day for two weeks or
more in a row (during the past 12 months) that they stopped doing some
usual activities.
Source: Illinois Youth Survey, 2012 County Level Report.
N/A - Not all counties have data. Only counties in which at least two school districts participated at any grade level are
included.
Substance Abuse
Substance abuse is a significant
public health issue, nationally and in
southern Illinois. The prevalence of
substance abuse among adults (18 and
over) residents was assessed by examining
chronic heavy drinking and binge drinking,
motor vehicle crash death rates, adult
smoking, and substance abuse within the
communities served by SIH facilities.
SIH emergency department data for
fiscal year 2012 shows that many frequent
ED users have substance abuse, acute
alcohol-related mental disorders, alcoholrelated psychoses, acute drug-related
mental disorders, and drug-related
psychoses.
Alcohol Behaviors
Location
Adults
who Binge
Drink
Excessive
Drinking
25.7%
23.5%
23.4%
17.1%
13.3%
20.6%
12.7%
10%
19%
N/A
12%
N/A
N/A
4%
Franklin
Jackson
Perry
Williamson
Johnson
Union
Saline
Source: Illinois Behavioral Risk Factor Surveillance System, 20072009.
Child Abuse
Location
Child Abuse
cases/1,000
children
Franklin
Jackson
Perry
Williamson
Johnson
Union
Saline
17.4
13.6
7.6
19.7
18.9
27.0
21.8
Source: Illinois Department of Children and Family Services. Child
Abuse and Neglect Statistics Annual Report – Fiscal Year 2011.
28 | P a g e
ILLINOIS – 2008-2010 National Survey on Drug Use and Health Sub-state Regions
Region V/Illinois
7.75% - Illicit Drug
Use in the Past
Month Among
Persons Aged 12 or
Older
25.43% Binge Alcohol
Use in the Past
Month Among
Persons Aged 12 or
Older
Source: http://www.samhsa.gov/data/NSDUH/substate2k10/RegionDefinitions/NSDUHsubstateRegDefs2010.htm; by State and Sub-state
Regions: Percentages, Annual Averages Based on 2008, 2009, and 2010 NSDUHs
The sub-state regions defined here were provided by the Illinois Department of Human
Services and are defined in terms of the State's 102 counties. Southern Illinois Healthcare
serves a subset of the Region 5 area.
29 | P a g e
Barriers to Medical Care
Adults with a Usual Source of Health Care
“Individuals who have a usual source of care are more likely to visit a doctor’s office or
clinic instead of an ED or hospital outpatient clinic.” An assessment of the ED Frequent Users
(5+ times during Fiscal 2012) for Southern Illinois Healthcare shows that the majority of visits
are primary care treatable. The most common diagnoses included: abdominal pain, urinary
tract infections, headache, dental disorders, backaches, pain, alcohol abuse, and anxiety and
depressive disorders.
HAVE USUAL PERSON AS HEALTH CARE PROVIDER
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Jackson
Franklin
Williamson
Perry
Johnson
Union
Saline
Yes
77.60%
87.90%
87.30%
88.00%
85.70%
86.30%
93.20%
No
22.40%
12.10%
12.70%
12.00%
14.30%
13.70%
6.80%
Insurance
DO YOU HAVE HEALTH CARE COVERAGE
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Jackson
Franklin
Williamson
Perry
Johnson
Union
Saline
Yes
88.90%
81.80%
83.20%
85.30%
90.30%
86.10%
85.20%
No
11.10%
18.20%
16.80%
14.70%
9.70%
13.90%
14.80%
30 | P a g e
SIH Coverage Estimates
In 2011, 19% of patients in the SIH service area were insured by Medicaid, 16% by
Medicare, 3% were dual-eligible , 3% had private-direct insurance, 31% were private-employer
self-insured, and 28% were uninsured.
Medicaid
19%
Uninsured
28%
Medicare
16%
Private-ESI
31%
Dual Eligible
3%
Private-Direct
3%
Medicaid recipients
In FY 2011, there were 62,850 Medicaid recipients in the SIH Service Area. This
represents approximately one-quarter of the area’s population. Fifty percent of the area’s
Medicaid recipients were children.
Illinois Department of Healthcare and Family Services
Number of Persons Enrolled in the Medical Program by County
State Fiscal Year 2011
County
Child
Franklin
Jackson
Johnson
Perry
Saline
Union
Williamson
6,007
6,823
951
2,419
3,948
2,571
8,700
Total for SIH
Service Area
31,419
Disabled
Adults
1,427
1,493
219
515
1,156
932
1,695
7,437
Other
Adults
3,601
3,743
526
1,385
2,118
1,450
5,089
17,912
Seniors
735
639
167
259
609
438
870
3,717
Total
Comprehensive
11,770
12,698
1,863
4,578
7,831
5,391
16,354
60,485
Total
Partial
454
600
43
167
275
263
563
2,365
Total All
Recipients
12,224
13,298
1,906
4,745
8,106
5,654
16,917
62,850
Source http://www2.illinois.gov/hfs/agency/Program%20Enrollment/Pages/default.aspx.
31 | P a g e
Financial
Even when health care providers are available, financial barriers to care are present.
Many people in our community put off medical care or prescription drugs due to cost, have
skipped doses or taken smaller amounts of medication than prescribed in order to make the
supply last longer. This can indicate a lack of insurance, under-insurance and poverty.
Financial Barriers to Care
35%
12 MOS: NO DOCTOR VISIT DUE TO COST Yes
12 MOS: DIDN'T GET MEDS DUE TO COST Yes
30%
12 MOS: COULD NOT AFFORD DENTIST Yes
25%
20%
15%
10%
5%
0%
Jackson
Franklin
Williamson
Source: Illinois Behavioral Risk Factor Surveillance System (2007-2009)
Perry
Johnson
Union
Saline
High Need Areas/Disparities
The Community Need Index (CNI), developed by Dignity Health, incorporates five
prominent socio-economic barriers that provide a way to quantify health care access and
highlight the severity of health disparity at the neighborhood level. There is a high correlation
between high CNI scores and high hospital utilization. This information allows SIH to better
focus resources and advocacy where they are most needed and can be most effective.
1
2
3
4
5
6
7
8
9
10
Prioritized by CNI Score
Only
Prioritized for SIH System
Highest need by # of
encounters X CNI
Prioritized by Population
Highest need by
population X CNI
Murphysboro
Carbondale-901
Harrisburg
Anna
Vienna
Carbondale-902
Carbondale-903
Herrin
Eldorado
Marion
Carbondale-901
Murphysboro
Marion
Carterville
Anna
DuQuoin
Carbondale-902
Herrin
West Frankfort
Desoto
Marion
Carbondale-901
Murphysboro
Harrisburg
Herrin
Benton
West Frankfort
Carterville
DuQuoin
Anna
32 | P a g e
Quality and Effectiveness of Care
Ambulatory Care Sensitive Conditions
An assessment of hospital utilization for Ambulatory Care Sensitive (ACS) conditions,
reflects community issues of access to, and quality of, ambulatory care in a given geographic
area. ACS or primary care treatable conditions are those for which good patient education and
adherence, outpatient care and monitoring can potentially prevent the need for hospitalization.
Early intervention (treatment) helps avoid complications and slows disease progression –
allowing people to stay healthier longer.
While other factors outside the direct control of the health care system, such as poor
environmental conditions or lack of patient adherence to treatment recommendations, can
contribute to hospitalizations, the information provides a good starting point for assessing the
overall health system performance in a community. It may help public health agencies, health
care systems, and others interested in improving health care quality in their communities focus
their attention on the most needed areas.
A review of utilization data (both inpatient and emergency department), shows that use
for ACS conditions is elevated in our area. It is likely that these utilization rates are due to
differences in access and/or quality as well as poorer underlying health status (disease
prevalence) in the community. For comparison, the 90th percentile benchmark nationally is 49
per 1,000 and in Illinois is 77 per 1,000.
Preventable Hospital Stays: Medicare Population
Location
discharges/1,000 Medicare
enrollees
Status
Jackson
70
Franklin
91
Williamson
106
Perry
109
Johnson
82
Union
92
Saline
117
Source: County Health Rankings, 2009, Comparison U.S. counties
33 | P a g e
Hospital Readmissions
Some readmissions are planned as a part of a specific treatment plan, or are medically
appropriate due to a change in condition or health status. More often however, hospital
readmissions within 30-days are being thought of as avoidable and as “indicators of poor care
or missed opportunities to better coordinate care.” (MedPAC, 2007) Many factors can
contribute to readmissions. For example, quality of care during the initial hospitalization, lack
of social support, follow-up care, understanding of discharge instructions, or other breakdowns
along the continuum of care. Southern Illinois Healthcare’s system-wide priorities include
Chronic Obstructive Pulmonary Disease (COPD), Acute Myocardial Infarction (AMI), Congestive
Heart Failure (CHF), Pneumonia, Septicemia, Diabetes, Sickle Cell Anemia, and major respiratory
infections and inflammations.
ED Utilization
An analysis of Emergency Department frequent users (5+ visits to ED in FY12) showed
that many of the conditions were non-emergent and/or primary care treatable. This is an
indication that the ED is being used for primary care. The most frequent diagnoses seen in the
ED included abdominal pain, urinary tract infections, migraine, headache, constipation, back
pain, chest pain and acute upper respiratory infections.
A stratification algorithm developed by New York University’s Center for Health and
Public Service Research to help classify emergency department utilization was used to explore
potential unmet community health care needs, provide insight into how well complications
from a number of common conditions are being avoided in the outpatient setting, and to
compare performance of local health care systems across communities.
Memorial Hospital of Carbondale (ED Overview)
Not Preventable/
Avoidable
37.7%
ED Care Needed
48.7%
Preventable
Avoidable
Emergent
82.6%
ED Visits
11.0%
Primary Care
Treatable
37.5%
Non-emergent
13.7%
Potential
access/barriers
to care issues
Ambulatory care
sensitive, chronic
care mgt issues,
potential
access/barriers
to care issues
34 | P a g e
Cancer Health
Cancer is the second leading cause of death in the seven county area served by SIH
facilities. The incidence rates in Southern Illinois are consistently higher than the rest of Illinois.
A comparison to 3,081 U.S. Counties also shows several locations where the cancer incidence
rates for specific types of cancer are higher. Indicators of “Red” on the colored gauge represent
the bottom or “worst” quartile when compared to other regions.
Location
Lung & Bronchus
Breast Cancer
Colorectal
Cancer
All Cancer
Cancer Incidence Rates (cases/100,000 population)
Franklin
111.0
120.4
Jackson
67.0
115.5
Perry
74.5
115.8
Williamson
92.3
82.0
120.5
Union
82.0
95.0
548.7
474.8
55.7
476.2
59.8
122.8
Johnson
Saline
63.2
54.7
506.2
59.1
542.8
109.3
46.6
439.3
142.6
59.2
501.0
Source: National Cancer Institute, State Cancer Profiles (2005-2009) Age-adjusted incidence rate/100,000; comparison 3,081 U.S. Counties
Cardiovascular Health
Overweight/obesity
The number of adults who are
overweight and obese is an important
measure of a community’s overall health.
Approximately two-thirds of the adults
in the community served by SIH facilities are
overweight or obese. Being overweight or
obese increases the risk for many diseases and
health conditions including heart disease, Type
2 diabetes, cancer, hypertension, stroke, liver
and gallbladder disease, respiratory problems,
and osteoarthritis. In addition to these health
effects, obesity carries significant economic
costs due to increases in necessary healthcare
spending and potential lost earnings.
Losing weight and maintaining a healthy
weight through physical activity, healthy eating,
and not smoking can help prevent and control
these diseases.
Adults who are Overweight or Obese
Location
Franklin
Jackson
Perry
Williamson
Johnson
Union
Saline
percent
65.3
55.4
66.8
68.9
59.9
65.3
65.4
35 | P a g e
Physical Activity
Strong evidence supports the health
benefits of regular physical activity. Physical
activity guidelines encourage participation
in moderate and vigorous physical activities
and muscle-strengthening activities.
Nationally, more than 80 percent of adults
do not meet the recommended physical
activity guidelines for both aerobic and
muscle-strengthening activities. The
percentage of adults meeting a moderate
activity standard (exercise 5 times per week
for 30 min.) is increasing in our community.
Adults Engaging in Moderate
Physical Activity
Location
percent
Status
Franklin
49.8
Jackson
56.9
Perry
59.2
Williamson
41.8
Johnson
46.0
Union
45.9
Saline
36.4
Nutrition
Vegetables and fruits are major contributors of essential nutrients. Adequate
consumption is associated with reduced risk of many chronic diseases. The percentage of
adults in our community who eat five or more servings of fruits and vegetables per day is below
recommended levels for health benefits, weight management, and chronic disease prevention.
Percent of Adults Meeting Recommended
Daily Fruit/Vegetable Intake
100%
80%
60%
40%
20%
19%
8%
12%
16%
14%
15%
14%
Williamson
Johnson
Union
Saline
0%
Franklin
Jackson
Perry
36 | P a g e
Children’s obesity
Childhood obesity has more than tripled since 1980. The National Center for Health
Statistics states that nearly 17 percent, or close to 12.5 million youth, age 2-19 in the U.S. are
obese. In addition, there are significant racial/ethnic and low-income disparities in obesity
prevalence among U.S. children. Childhood obesity has both immediate and long-term health
impacts. Low-Income Preschool Obesity measures the percentage of children aged 2-4 living in
households with an income less than 200% of the poverty level who are obese.
“There is a positive relationship between food insecurity and obesity in low-income children.”
Craig Gundersen, University of Illinois. Food Insecurity, Stress, and Childhood Obesity
Low-Income Preschool Obesity
Comparison: 2,637 U.S. counties and county equivalents
Location
Percent
Status
Franklin
12.8
Jackson
10.8
Perry
9.4
Williamson
13.1
Johnson
10.8
Union
14.8
Saline
7.2
Source: U.S. Department of Agriculture - Food Environment Atlas
37 | P a g e
Chronic Obstructive Pulmonary Disease (COPD)
COPD is a preventable, treatable, but chronic lung disease that makes it difficult to
breathe. Also called chronic lower respiratory disease, chronic bronchitis, emphysema or a
combination of both, it is the third leading cause of death in our community with 5,299
reported deaths (5.3% of total) in 2009.
Diabetes Health
The percentage of adults who have ever been diagnosed with diabetes is slowly
increasing. Diabetes is a leading cause of death in our community. It has a harmful effect on
major organ systems and contributes to cerebrovascular diseases (including ischemic heart
disease and stroke). Diabetes Mellitus was responsible for 2,741 deaths in Illinois in 2009.
Adults with Diabetes
(Not including women with diagnosed with diabetes during a pregnancy).
Location
Franklin
Jackson
Perry
Williamson
Johnson
Union
Saline
Percent of Adults told have
diabetes
Percent of Adults with
Diabetes who had Blood
Glucose Test in past 12
months
12.9%
59.2%
5.0%
50.6%
11.2%
59.3%
15.1%
59.5%
10.6%
57.0%
10.2%
56.3%
12.8%
68.5%
38 | P a g e
Risk Behaviors
Sexually Transmitted Infections
Location
Gonorrhea Incidence
Rate
Chlamydia Incidence
Rate
HIV Diagnosis Rate
Cases/100,000 population Comparison: IL Counties
Franklin
Jackson
Perry
Williamson
28.2
297.3
2.9
189.6
899.1
9.3
47.6
199.2
10.2
57.1
272.4
4.2
Johnson
40.5
Union
1.6
Saline
4.0
Teen Births
The number of births to teens is a health concern for both the mother and the child.
Babies born to teen mothers are more likely to be premature and/or have a low birth weight
which is a determinant of mortality, morbidity and disability in infancy and childhood.
Teenagers’ health, social and educational development can also be adversely affected.
Percentage of all live births to females under 18 years of age
Comparison: IL Counties
Location
percent
Status
Franklin
4.0
Jackson
2.7
Perry
2.3
Williamson
3.3
Johnson
1.8
Union
6.7
Saline
2.9
39 | P a g e
Physical Environment
Access to Recreational Facilities
Recreation and Fitness Facilities
Comparison: 3,141 U.S. counties and county equivalents
Location
facilities/1,000
population
Status
Median for 3,141 U.S. counties and
county equivalents is 0.07/1,000 population
Franklin
Jackson
Perry
Williamson
Johnson
Union
Saline
0.153
0.069
0.134
0.077
0.146
0.056
0.0
Above median
At median
Above median
At median
Above median
Below median
Below median
Source: U.S. Department of Agriculture - Food Environment Atlas, 2009.
Air Quality
Air pollution-particulate matter days represent the number of days each year that air
quality was considered unhealthy due to small particles in the air. Guidelines are set according
by the Centers for Disease Control and Prevention (CDC) and the Environment Protection
Agency (EPA). Ambient air pollution contributes to decreased lung function and adversely
affects respiratory and pulmonary systems. The national benchmark, 90th percentile, is zero.
Similarly, air pollution-ozone days are the number of days each year that air quality was
considered unhealthy due to ozone levels. Ozone at the ground level is an unstable and
poisonous form of oxygen, is highly corrosive and can damage the respiratory track when
inhaled. The national benchmark for ozone (90th percentile) is zero.
Location
Franklin
Jackson
Johnson
Perry
Saline
Union
Williamson
Air pollutionparticulate
matter days
0
0
0
0
0
0
0
Air pollutionozone days
0
0
0
0
0
0
0
Source: Univ. of Wisconsin, PHI County Health Rankings, 2012.
40
Transportation
A recent survey of health care providers in the southern thirty-four counties in Illinois
showed a perceived unmet need for non-emergency medical transportation. The survey was
conducted by the Rural Medical Transportation Network in April 2011, as a project of the SIU
Center for Rural Health & Social Service Development. Eighty-nine respondents, primarily
hospitals, federally qualified health centers, and health departments, were asked to respond to
various questions regarding medical transportation from their perspective as healthcare
providers. Key findings are listed below.
91 percent report that a better non-emergency medical transportation (NEMT) system is
at least somewhat needed; 51 percent report that this is extremely needed.
57 percent agree or strongly agree that patients miss appointments because of a lack of
NEMT.
55 percent agree or strongly agree that the health of their patients is negatively
impacted because they miss health care appointments due to the inability to secure
transportation to/from home.
53 percent agree or strongly agree that patients often utilize ambulances for
transportation to the ED because they could not secure NEMT to/from health care
appt/treatments.
25 percent of HCP responded that their patients were often hospitalized because their
health had deteriorated, due to the patient’s inability to obtain a ride to their
appointments/treatments. 57 percent neither agreed nor disagreed.
72 percent stated that 1-3 patient appointments are missed in their department/facility,
per week, due to transportation issues. 16% stated that 4-9 appointments are missed,
while 7 percent stated that 10+ appointments are missed.
Access to Healthy Foods
Food security means that people have access to enough food, at all times to live an
active and healthy life. Not having enough food or limited access to healthy food options,
impacts the well-being of children, families, adults, elderly, and whole communities. Food
insecurity likely reflects a household’s need to make trade-offs between essentials such a
housing, transportation, medical bills and purchasing nutritionally adequate foods.
Limited access to healthy foods in our area may contribute to the childhood obesity
epidemic by making it more difficult to instill healthy eating habits early in life. On a national
41
scale of 0 to 100, where zero means “no food retailers that typically sell healthy food” and 100
where there are “only food retailers that sell healthy food”, the national average score in 2011
was 10. Illinois scored 8, below the national average.
Source:CDC: "Children's Food Environment State Indicator Report, 2011." News release, CDC.
Researchers say “lack of access to supermarkets and other venues where healthy foods are
available for sale have been associated with a lower quality diet and increased risk of obesity.”
(CDC, 2011) These areas, called “food deserts” are found in low-income communities where a
large number of residents have limited access to healthy foods at a supermarket or large
grocery store.
A "low-income community," is a census tract with either a poverty rate of 20 percent or
higher, or a median family income at or below 80 percent of the rest of the area.
A "low-access community," is where at least 500 people and/or at least 33 percent of the
rural census tract's population live more than 10 miles from a supermarket or large grocery
store
Much of the Southern Illinois Healthcare service area is located in food desert areas, meeting
the criteria for both low-income and low-access communities.
Source: Economic Research Service (ERS), U.S. Department of Agriculture (USDA). Food Desert Locator. http://www.ers.usda.gov/dataproducts/food-desert-locator.aspx. Last accessed 9/1/12.
List of Indicators
42
Measure
Data Source
Years of
Data
Population, race/ethnicity, age,
gender, geography, economy
Median household income
% below poverty line
% Children living in poverty
Illinois Behavioral Risk Factor Surveillance System;
American Community Survey
2007-2009
2010
2010
Mortality
Premature death (YPLL)
Cause of Death
Mortality Rates
Health Status
Morbidity
County Health Rankings
Poor or fair health
Poor physical health days
Poor mental health days
Low birth weight
National Center for Health Statistics
IDPH Health Statistics
National Cancer Institute
IQuery, Illinois Department of Public Health
Univ. of Wisconsin, PHI County Health Rankings
Illinois Behavioral Risk Factor Surveillance System
IQuery, Illinois Department of Public Health
2006-2008
2008
2005-2009
2007
2010-2012
2007-2009
2007-2009
2007-2009
2008,2009
SIH System Data
County Health Rankings; Health Resources &
Services Administration
Illinois Department of Healthcare and Family
Services
U.S. Department of Health and Human Services,
Health Resources and Services Administration,
Shortage Designation Branch; IDPH
SIU Center for Rural Health and Social Service
Development
SIH ED Dashboard, System
Dignity Health (formerly Catholic Heath Systems)
Medicare/Dartmouth Institute
2011
2009
Illinois Department of Healthcare and Family
Services Potentially Preventable Readmissions
(PPR) Analysis, August 2012; Illinois Hospital
Association, Compdata, August 2012.
2011, 2012
Illinois State Board of Education School Report
Cards
American Community Survey; U.S. Census Bureau,
State & County QuickFacts
Bureau of Labor Statistics
2011-2012
DEMOGRAPHICS
HEALTH OUTCOMES
HEALTH FACTORS
SYSTEMS (CLINICAL CARE)
Access to Care
Uninsured adults
Primary Care Providers
12 mo. could not afford dentist
Do you have healthcare coverage
Usual healthcare provider
Medicaid
Medically Underserved Areas/
Health Provider Shortage Areas
Transportation
Disparities
Quality of Care
Non-emergency medical
transportation
Avoidable ED Utilization
Community Need Index (CNI)
Preventable hospital stays
Diabetic screening
Mammography screening
Colorectal cancer screening
Influenza/Pneumonia Vax
30-day all cause readmissions
2007-2009
2007-2009
2007-2009
2011
2009-2012
2011
2012
2012
2009
2007-2009
2007-2009
2007-2009
SOCIOECONOMIC FACTORS
Education
High school graduation
Bachelors degree or higher
Employment
Unemployment
Income
Children in poverty
Median household income
People living in poverty
Supplemental Nutrition (SNAP)
Free/reduced lunches
Single-parent households
Inadequate social support
Food Assistance
Family/Social Support
American Community Survey; U.S. Census Bureau,
State & County QuickFacts
2006-2010
June, October
2012
2006-2010
U.S. Dept of Agriculture – Food Environment Atlas
2007
Behavioral Risk Factor Surveillance System
2006-2010
2007-2009
43
Community Safety
Violent Crime
Uniform Crime Reporting, Federal Bureau of
Investigation
2009
Built Environment
Access to healthy foods
2011
Air Quality
Access to recreational facilities
Air pollution-particulate matter days
CDC: "Children's Food Environment State Indicator
Report, 2011."
Census County Business Patterns
Univ. of Wisconsin, PHI County Health Rankings ;
U.S. Environmental Protection Agency/ Centers for
Disease Control and Prevention
Univ. of Wisconsin, PHI County Health Rankings ;
U.S. Environmental Protection Agency/ Centers for
Disease Control and Prevention
Excessive drinking
Behavioral Risk Factor Surveillance System
2004-2009
Motor vehicle crash death rate
IQuery, Illinois Department of Public Health;
National Center for Health Statistics
Illinois Behavioral Risk Factor Surveillance System;
National Survey o Drug Use and Health
Illinois Department of Children and Family Services
U.S. Department of Agriculture – Food Environment
Atlas
2006-2008
2009
Teen birth rate
HIV
Hospital Discharges by top DRG
volume
IPLAN priorities
SIH Internal system data
2009
2005-2011
2010
IPLANs
2010-2017
Rank order top priorities
Focus groups
Email survey
Ranking group process
2012
2012
2012
2012
PHYSICAL ENVIRONMENT
Air pollution-ozone days
2009
2012, 2010
2012, 2010
HEALTH BEHAVIORS
Alcohol, Tobacco &
Other Drugs
Adult smoking
Substance Abuse
Overweight/Obesity
Exercise
Diet
High risk sexual
behavior
HIV
Healthcare Utilization
Stakeholder priorities
Local Health Dept.
Patients groups
Residents
External team
Internal Team
Child Abuse
Adult overweight/obesity
Childhood obesity
Adults, Moderate Activity
Adults, Fruit/Vegetable
Consumption
Sexually transmitted infections
2007-2009
2007-2009
2010
2011
2007-2009
2010
2007-2009
2007-2009
44
2012 CHNA
IMPLEMENTATION STRATEGY
Appendix 2
To
2012 Community Health Needs Assessment
“Improve health…by supporting proven interventions to address behavioral, social and
environmental determinants of health in addition to delivering higher-quality care.”
National Quality Strategy (2011)
45
Introduction
This document outlines Southern Illinois Healthcare’s integrated implementation strategy for
improving health for all those in the communities we serve.
During 2012, Southern Illinois Healthcare along with a diverse
group of community partners conducted a Community Health
Needs Assessment (CHNA) designed to spotlight health and
quality of life issues in our community. Using a framework of
behavioral, social and environmental factors, community
health needs were explored. The systematic process helped
identify issues where changes in the healthcare delivery
system and continued collaboration could improve patient
care, preventive services, and overall health and quality of
life.
Building on the Foundation
The 2012 CHNA identified a number of unmet or
partially met health needs in the communities served by
SIH. Providing greater detail about how the needs will
be addressed is the major purpose of this document.
Following the Institute for Healthcare Improvement’s
(IHI) Triple Aim dimensions, this implementation
strategy seeks to integrate five priority areas identified
through the CHNA, to improve the patient experience of
care (including quality and satisfaction), improve
population health in the Southern Illinois region, and
reduce unnecessary per capita cost of health care.
Based on IHI’s concept design, our strategies
incorporate:
Focus on individuals and families
Redesign of primary care services and structures
Population health management through
collaboration
Cost control platform
System integration
5 Priority Areas
High impact clinical
and preventive
services
Access to Care
Quality and
Behavioral Risk
Factors
Cancer Disparities
46
Each priority area is addressed according to the hospital’s specific programs and resources,
assets and engagement within the community. Any health needs the hospital does not intend
to address are identified and rationale for not addressing the area is provided.
Source: Design of a Triple Aim Enterprise. Cambridge, Massachusetts: Institute for Healthcare Improvement;
2012. (Available on www.IHI.org)
To compare our progress and set targets for improvement,
the Healthy People 2020 objectives and benchmarks for
nationwide health improvement priorities are referenced
when applicable.
47
Implementation Planning Model
An implementation planning logic model was used to clearly identify specific priority areas,
overall goals and strategic approach, the actual activities planned or implemented to address
the need, and suggested objectives to measure progress.
Identified Need
Goals
Objectives
Strategies
Initiatives
What are the priority
areas?
What are we trying to
accomplish?
What is our target to
improve?
Our approach to
addressing the need
Programs, resources
& collaborations
Summary of Priority Topics
Clinical &
Preventive
Access
Quality &
Effectiveness
V
Diabetes
X
Smoking
X
Flu Vax
X
X
Pneumo Vax
X
X
CHF
X
X
COPD
X
X
Substance Abuse
Behavioral
Risk Factors
Cancer
X
(Vulnerable)
X
X
(Rural Disparity)
X
X
Mental Health
(Vulnerable)
Oral/Dental
X
Physical Activity
X
X
Nutrition
X
X
Hypertension
X
Obesity
X
Blood-related Illness
Low-birth Weight
X
X
V
(Vulnerable)
X
48
Topic 1 High impact clinical and preventive services
Identified Needs:
Influenza/Pneumonia Vaccinations; Preventive Screenings; and
outpatient/community chronic disease management for Diabetes, CHF, and COPD
Goals
Initiatives
•Prevent or delay the onset of
disease for individuals &
population groups
•Reduce the progression &
complications of chronic
disease
•Reduce avoidable, hospital
admissions & health care
procedures for those with
chronic disease
Objectives
Strategies
•Increase the number of adults
with diabetes who had their
HbA1c tested in the past 12
months.
•Decrease the number of adults
with diabetes who had poorly
controlled HbA1c (>9.0%).
•Decrease the number of adults
with diabetes who smoke.
•Increase the proportion of
persons with a usual primary
care provider.
adults receiving recommended
preventive screening and
immunizations.
•Decrease the number of
hospital readmissions for
ambulatory care sensitive
conditions.
•Increase awareness of and
participation in prevention
and control/self management
of diabetes
•Implement best-practices in
the prevention, detection &
management of disease
•Redesign of primary care
services & structures
•Pursue strategic alliances with
complementary community
partners to reduce the burden
of chronic disease
•Integrate and expand
initiatives to optimize care
transitions
•Certified Diabetes Educators/Registered Dieticians
•THRIVE Diabetes Self-Management Program
•Project POWER
•Healthy Communities Coalitions
•Diabetes Today Resource Team
•Healthy Living Action Team
•Clinical Integration
•Patient Centered Medical Home
•Disease Registries
•Health Information Exchange
•Preventive screenings and services
•Smoking cessation support
•Smoke-free workplace
•Employee wellness programming
•Please refer to activity descriptions provided on pages 13-19.
49
Current Status
MHC Service Area
Comparison
Healthy People 2020 Targets
Diabetes
Increase the proportion of adults with diabetes who have an
annual Hemoglobin A1c test by 10 percent
annual dilated eye examination to 58.7 percent
Increase the proportion of adults with diabetes who have at
least an annual foot examination to 74.8 percent
Source: Illinois BRFSS, 2007-2009
Increase the proportion of persons with diagnosed diabetes
Please Note: In process of obtaining baseline and targets to
who receive formal diabetes education to 62.5 percent
improve using NCQA: HEDIS 2012 Measure Set
Smoking
Percent of Adults who Smoke
Reduce cigarette smoking by adults to 12.0 percent.
Franklin 28.3% Saline 20.4%
Jackson 25.8%
Union 27.7%
Johnson 21.7% Williamson 27.4%
Perry 24.0%
Percent of Adults with Diabetes who had Blood Glucose
Test in past 12 months.
Jackson 50.6%
Union 56.3%
Perry 59.3%
Flu Vax
Increase the percentage of adults 18-64 who are vaccinated
annually against seasonal influenza to 80 percent
Percent of adults with influenza vaccination in last 12 mo.
Franklin 34.0% Saline 48.9 %
Jackson 35.5% Union 45.3%
Perry 33.2%
Percent of adults who ever had a pneumonia vaccination
Franklin 25.1% Saline 36.6 %
Perry 28.8%
Pneumovax
Increase the percentage of adults 65+ who are vaccinated
against the pneumococcal disease to 90 percent.
CHF
Percent of acute care readmissions within 30 days (index
visit with primary diagnosis CHF).
MHC 18.2%
No HP2020 target
SIH Target to improve: Reduce the rate of avoidable
readmissions for CHF among adults by 20 percent from
system baseline.
Source: Illinois Potentially Preventable Readmissions Report Set,
Illinois Hospital Association July 1, 2011 – June 30, 2012 Admissions
COPD
visit with primary diagnosis COPD).
MHC 17.5%
Illinois Hospital Association July 1, 2011 – June 30, 2012 Admissions
No HP2020 target
readmissions for COPD among adults by 20 percent from
system baseline.
Proportion of women receiving a screening mammography
HP 2020 Target already met: Increase the proportion of
women who receive a breast cancer screening based on
Jackson 95.7%
Union 85.2%
most recent guidelines to 81.1 percent
Perry 86.1%
Increase the proportion of adults who receive a colorectal
cancer screening based on most recent guidelines to 70.5
Proportion of adults who receive a CRC screening
percent
Perry 50.0%
50
Topic 2 Access to Care
Identified Needs:
Oral/Dental Health; Mental Health & Alcohol/Substance Abuse, Blood-related Illness
Objectives
Goals
Initiatives
•Remove barriers to health
care.
•Provide the right care, in the
most appropriate setting, at
the right time.
persons with a usual primary
care provider.
persons with a usual dental
care provider.
emergency department visits
for behavioral/mental health
conditions.
•Decrease the number of ED
visits for dental conditions.
Strategies
•Ensure access to care for
persons with mental illnesses
and substance abuse disorders
•Ensure access to care for
primary/preventive dental
care
•Engage with Healthy
Communities Coalitions to
promote and facilitate Access
to Care
•Promote health equity
through policy and advocacy.
•Promote/communicate
currently available resources
•Collaborate to support nonemergency medical
transporation
•Emergency mental health outpatient stabilization facility
•Healthy Communities Coaltions
•Joint Access to Care Team
•Oral/Dental Health Referral Initiative
•Medical-Legal Partnership of Southern Illinois
•Healthy SI Delta Network (HSIDN)
•Center for Rural Health and Social Service Development (CHRSSD)
Transportation Network (non-emergency)
•HIV Care Connect
51
Current Status
MHC Service Area
Adults who binge drink
Franklin 25.7%
Saline 12.7%
Jackson 23.5%
Union 20.6%
Johnson 13.3%
Williamson 17.1%
Perry
23.4%
Excessive drinking alcohol behaviors
Range (counties): 4 to 19 percent
Comparison
Substance Abuse
Reduce the proportion of adults who drank excessively in
the previous 30 days to 25.3
(HP2020-Developmental) Increase the proportion of persons
who are referred for follow-up care for alcohol problems,
drug problems after diagnosis, or treatment for one of these
conditions in hospital emergency department (ED)
Source: Illinois BRFSS, 2007-2009.
Mental Health
Please Note: In process of obtaining baseline and targets
Increase the proportion of primary care physicians who
to improve using NCQA: HEDIS 2012 Measure Set
screen adults aged 19 years and older for depression during
office visits to 2.4 percent; and youth aged 12 to 18 to 2.3
Calendar year 2012 baseline for 3+ Visits
percent.
MHC n=39
SIH System Target: Decrease the number of patients with
primary MH Diagnosis accessing the ED 3 or more times by
10 percent.
Calendar year 2012 baseline
MHC n=510
HIV, Sickle-cell Anemia, Thalessemia
Baseline TBD
Oral/Dental
SIH System Target: Reduce number of ED Visits for targeted
Dental Conditions by 10%
Blood-related Illness
(HP2020-Developmental, target not set) Increase the
proportion of persons with a diagnosis of
hemoglobinopathies and their family who are referred for
evaluation and treatment
52
Topic 3 Quality and Effectiveness of Care
Identified Needs:
Readmissions within 30 days for CHF, COPD, Pneumonia, AMI
Goals
Objectives
Initiatives
•Ensure all patients receive
high quality, timely and
appropriate care.
preventable hospital
readmissions.
•Increase the number of high
risk/vulnerable population
patients receiving community
case management assistance.
•Increase patient /caregiver
engagement in discharge
process (extent felt ready for
discharge, understand
instructions/medication, etc.)
•Decrease ED utilization for
ambulatory care sensitive
chronic conditions
Strategies
•Pursue health equity by
reducing variations in care.
•Expand ED care planning
•Optimize care transitions
through expansion of
community case management
models
•Integrate initiatives to
improve communication and
care transitions
•Engage post-acute care
stakeholders in care planning
and palliative care processes.
•Cardiac Management Center (CHF Clinic/Get with the Guidelines -GWTG)
•Premier's Partnership for Patients
•Preventing Readmissions Through Effective Partnerships (PREP)
•Enhanced community case management for high risk and vulnerable populations
(Bridge Care Transitions and Coleman Case Management Model)
•Prairie Heart (CHF Patients/outpatient infusion therapy)
•Coordinated post-acute care patient follow-up to link with primary care
•Ortho/Joint Camp (early ambulation and "ready for discharge" home simulation
education)
•IT system integration for efficient and effective discharge planning
53
Current Status
MHC Service Area
Comparison
AMI
visit with primary diagnosis AMI).
MHC 18.8%
No HP2020 target
readmissions for AMI among adults by 20 percent from
system baseline.
Illinois Hospital Association Oct. 1, 2011 – Sept. 30, 2012
Admissions
CHF
visit with primary diagnosis CHF).
MHC 18.3%
No HP2020 target
readmissions for CHF among adults by 20 percent from
system baseline.
Admissions
COPD
visit with primary diagnosis COPD).
MHC 19.1%
Admissions
No HP2020 target
readmissions for COPD among adults by 20 percent from
system baseline.
Pneumonia
No HP2020 target
readmissions for PNE among adults by 20 percent from
system baseline.
visit with primary diagnosis PNE).
MHC 10.7%
Admissions
54
Topic 4 Behavioral Risk Factors
Identified Needs:
Diabetes, CVD, Obesity, Chronic Lower Respiratory Diseases, Low-birth Weight
Goals
Objectives
•Decrease population
behavioral risk factors to
support healthy lifestyles
•Promote health enhancing
policies, systems, and
environmental supports.
•Decrease the proportion of
adults who smoke
adults/children who are
overweight/obese.
adults/children who have
access to healthy foods.
adults and children who
engage in moderate to
strenuous physical activity
(guidelines)
•Increase the number of
worksites with wellness
policies.
Strategies
•Identify and engage key
leaders for at risk populations
and partner to develop
culturally appropriate
strategies to promote healthy
lifestyles and prevention
behaviors
•Promote inclusion of healthrelated activities in nontraditional settings
(e.g., churches & faith-based
organizations)
•Promote availability of healthy
food choices in
schools, worksites and
neighborhoods
•Promote physical activity
•Engage the community to
support tobacco-free
environmens
•Promote awareness of
currently available resources
Initiatives
•Health Living Action Team
•Healthy Weight Collaborative
•Project POWER
•Healthy SI Delta Network
•We Choose Health - Community Transformation Grant
•Smoke Free Public Places
•Smoke Free Housing
•Worksite Wellness
•Coordinated School Health
•Joint Use Agreements
•Illinois Tobacco Free Communities
•Prenatal care classes
55
Current Status
MHC Service Area
Comparison
Physical Activity
Adults engaging in moderate physical activity
Increase the percentage of adults who engage in moderate
physical activity for at least 30 minutes on five days per week
Jackson 56.9%
Union 45.9%
by 10 percent.
Perry 59.2%
SIH SOFIT measures: 50 percent of time MVPA (new
Coordinated School Health - measure of percent of time
schools); 65 percent of time MVPA (continuing schools)
spent in Moderate to Vigorous Physical Activity
Nutrition
Adults meeting recommended daily fruit/vegetable intake
Increase the percentage of adults who eat fruits and
Franklin 8% Saline 14%
vegetables five or more times per day by 10 percent.
Jackson 19% Union 15%
Johnson 14% Williamson 16%
Perry 12%
High Blood Pressure
High Blood Pressure Prevalence
Reduce the proportion of adults with hypertension to 26.9
Franklin 43.6 % Saline 39.0 %
percent.
Jackson 23.6 % Union 33.1%
Perry 34.9 %
Smoking
Perry 24.0%
Diabetes
Percent of Adults with Diabetes who had Blood Glucose
Test in past 12 months.
annual Hemoglobin A1c test by 10 percent.
Increase the proportion of persons with diagnosed diabetes
who receive formal diabetes education to 62.5 percent
Perry 59.3%
Obesity
Adults who are overweight or obese
Reduce the proportion of adults who are obese to 30.5
percent
Reduce the proportion of children and adolescents aged 2 to
19 years who are considered obese to 14.5 percent.
Perry 66.8%
Low-income preschool obesity
Perry 9.4% Source: USDA - Food Environment Atlas
Low Birth Weight
Babies with low birth weight
Reduce low birth weight (LBW) and very low birth weight
(VLBW) to 7.8 percent
Jackson 7.7%
Union 9.8%
Perry 9.6% Source: IDPH, Health Statistics, 2009
56
Topic 5 Cancer Disparities
Goals
Objectives
Strategies
•Reduce cancer incidence rates
•Increase early detection of
cancer(s)
•Increase cancer survival rates
adults who smoke
adults receiving recommended
cancer screening
•See additional Behavioral Risk
Factors objectives
•Engage community in
prevention focus (through
reduction in behavioral risk
factors)
•Promote screening and early
detection
•Increase community
member’s knowledge of
available support resources
•Pursue strategic alliances with
complementary
community, state and national
partners to reduce the burden
of cancer in Southern Illinois
Initiatives
•Health Living Action Team
•Healthy Weight Collaborative
•Project POWER
•Healthy SI Delta Network
•We Choose Health - Community Transformation Grant
•Smoke Free Public Places
•Smoke Free Housing
•Worksite Wellness
•Joint Use Agreements
•Illinois Tobacco Free Communities
•Cancer partnerships and clinical trials
57
Current Status
MHC Service Area
Comparison
Lung
Age-adjusted death rate due to lung cancer per 100,000
population
Franklin 74.1% Perry 55.0%
Saline 77.6%
Jackson 50.1%
Union 61.9%
Reduce lung cancer death rate to 45.5 deaths per 100,000
population
Source: NCI,(2005-2009) State Cancer Profiles
Breast
Age-adjusted death rate due to BC per 100,000
population.*
Franklin 28.9%
Perry 25.1%
Saline 29.7%
Jackson 27.4%
Union 25.7%
Johnson ≤3 cases Williamson 22.2%
Reduce breast cancer death rate to 20.6 deaths per 100,000
females
Source: NCI, (2005-2009) State Cancer Profiles
Colorectal
Age-adjusted death rate due to CRC per 100,000
population
Saline 21.5%
Reduce the colorectal cancer death rate to 14.5 deaths per
100,000 population
All Cancers
Age-adjusted death rate due to cancer (All) per 100,000
population
Franklin 215.7 Perry 197.1
Saline 223.5
Jackson 194.4
Union 195.4
Johnson 218.7 Williamson 212.5
Reduce the overall cancer death rate to 160.6 deaths per
100,000 population
Proportion of women (40 and older) receiving a screening
mammography
Saline 91.8%
Jackson 95.7%
Union 85.2%
Proportion of adults who receive CRC screening
Franklin 67.2% Perry 50.0% Saline 52.0%
HP 2020 Target already met: Increase the proportion of
women who receive a breast cancer screening based on
most recent guidelines to 81.1 percent
Increase the proportion of adults who receive a colorectal
cancer screening based on most recent guidelines to 70.5
percent
Physical Activity
Adults engaging in moderate physical activity
Saline 36.4%
Increase the percentage of adults who engage in moderate
physical activity for at least 30 minutes on five days per week
by 10 percent.
Nutrition
Adults meeting recommended daily fruit/vegetable intake
Franklin 8%
Perry 12%
Saline 14%
Jackson 19% Union 15%
Johnson 14% Williamson 16%
Increase the percentage of adults who eat fruits and
vegetables five or more times per day by 10 percent.
Smoking
Saline 20.4%
Jackson 25.8%
Union 27.7%
58
High impact clinical and preventive services
INITIATIVES
Increase awareness of and participation in prevention and control/self management of diabetes
Certified Diabetes Educators/Registered Dieticians
THRIVE Diabetes Self-Management Program – promote awareness of and participation in
disease self-management educational programming
Project POWER – a culturally specific diabetes prevention education project developed by the
American Diabetes Association for African American church congregations. Jackson County
Health Department and Southern Illinois Healthcare partner to bring the program to churches in
Jackson County to educate, teach diabetes self-care, and prevent new cases of diabetes in the
African American community. The nine churches currently participating in Project POWER
include: Praise Central Church of Deliverance (Carbondale), Faith Temple Church of God in Christ
(Carbondale), New Zion Missionary Baptist Church (Carbondale), Rock Hill Missionary Baptist
Church (Carbondale), Hopewell Missionary Baptist Church (Carbondale), March of Faith
(Carbondale), Mt. Olive Baptist Church (Colp), New Birth Kingdom International (Carbondale)
Smoking Cessation Support
Implement best-practices in the prevention, detection & management of disease.
SIH Employee Wellness programming – providing risk assessments and screenings (skin,
nutrition, weight control, cancer), free seasonal influenza vaccinations, and smoking cessation
assistance to employees to support early detection, health education and treatment
interventions and positive health behaviors.
SIH System Smoke-free Workplace
Clinical Integration /Redesign of primary care services and structures
Patient Centered Medical Home (PCMH) - Federally Qualified Health Centers (FQHCs) and
SIH Primary care providers/clinics are actively engaged to achieve level three PCMH
recognition. Community partners include: Christopher Rural Health and Primary Care,
CHESI, Shawnee Health Service, Center for Medical Arts, SIU Family Practice Carbondale, SIU
Family Practice West Frankfort
o Increase/enhance primary care access through expanded hours and same day
scheduling, improved health information supports, and long-term partnerships with
clinicians; clinician-led teams coordinating care, especially for prevention and chronic
conditions, as well as with other clinicians and community supports
o Patient-centered (patient and provider) shared decision making between patients and
providers for more informed choices, treatment and medication adherence.
o Incorporate clinical quality measures to reduce emergency department (ED) utilization,
acute and ambulatory care services (ACS)/Inpatient admissions and readmissions.
Disease Registries
Health Information Exchange
Pursue strategic alliances with complementary community partners
Healthy Communities Coalitions
Southern Illinois Healthcare’s Community Benefits department convenes and facilitates Healthy
Community Coalitions in four southern Illinois counties. Fostering community collaboration and
59
leveraging the collective resources of agencies serving southern Illinois residents, the SIH Healthy
Communities initiative is working to improve the overall health and well-being of those residing in
communities served by SIH hospitals. This is done through both local and regional efforts to foster
increased individual and community capacity with the goal of achieve healthy communities.
Jackson County Healthy Communities Coalition (JCHCC)
Mission: To serve as a catalyst for improving the health and overall quality of life of Jackson County
residents by promoting healthy lifestyles, encouraging positive youth development, decreasing
substance abuse, improving mental health, and increasing access to health care.
Vision: We will be a catalyst for improving the health and overall quality of life within Jackson
County, Illinois.
Action Teams: Sexual Health, Access to Care Team (joint efforts among Jackson, Franklin, Williamson
counties), Family Violence, Healthy Living, Behavioral Health, and Positive Youth Development.
JCHCC Goals:
1. Raise Awareness: To increase the knowledge of consumers and providers about matters
relevant to the health of the communities of Jackson County.
2. Develop Projects: To encourage the growth or development of new projects, which address
unmet needs or gaps in health services.
3. Foster Collaboration: To bring consumers and / or providers together for the express
purpose of efficiently coordinating services and maximizing resources to improve the health
of the communities.
4. Develop Plans and Reports: To support the collection, tracking and reporting of data
relevant to the health status of the county.
5. Encourage Advocacy: To educate the communities on grants, regulations, ordinances,
policies, and legislation that will improve the health of the community.
6. Access Funding: To heighten awareness, support agencies efforts to access funding and
share information about private and public resources that are available to improve the
health of the communities.
Franklin-Williamson Healthy Communities Coalition (FWHCC)
Mission: To actively pursue a healthier community.
Vision: We will be a catalyst for improving the health and overall quality of life within Franklin and
Williamson Counties in Illinois.
Action teams: Healthy Seniors, Access to care (joint efforts among Jackson, Franklin and Williamson
counties)
Goals:
1. Support the Collection, Tracking and Reporting of Relevant County Healthy Data: To actively
participate in the county needs assessment plan process (IPLAN) and any other relevant
projects as they are identified.
2. Develop Plans & Reports: To increase the awareness of consumers and providers about
matters relevant to the health and resources of the communities of Franklin & Williamson
Counties.
3. Develop Projects: To encourage the growth or development of projects, which address
unmet needs or gaps in health services.
4. Foster Collaboration: To bring consumers and/or providers together for the express purpose
of efficiently coordinating services and maximizing resources to improve the health of the
communities.
60
5. Encourage Advocacy: To educate the communities on regulations, ordinances, policies, and
legislation that will improve the health of the community.
Perry County Healthy Communities Coalition (PCHCC)
The Perry County HCC is currently forming their Mission, Vision, Goals and Action teams.
Healthy Southern Illinois Delta Network (HSIDN)
The HSIDN is a network of public health, community health centers, hospitals and other interested
stakeholders from diverse sectors of society interested in improving the health of their
communities. The HSIDN is led by a steering committee which includes administrators of the seven
public health departments serving the counties that comprise the geographic area, a representative
from Southern Illinois Healthcare’s Community Benefits Department and the Director of the SIU
Center for Rural Health and Social Service Development.
Members are committed to improving the health status of the residents in the southern-most
sixteen counties in Illinois. The primary goal of the HSIDN is to create a framework for regional
collaboration and coalition building with a mission of transforming southern Illinois into a region
that supports and enhances healthy living. The HSIDN focus is to utilize a framework of policies,
systems and environmental supports for health, community engagement, education, health
promotion, resource sharing.
Illinois Delta Network: Coordinated School Health/CATCH on to Health! engages schools and
families in educational activities to promote healthy living, good nutrition, and increased
physical activity, in turn preventing or delaying the onset of disease.
Parish nurses/faith community: engage vulnerable populations with health promotion and
education regarding healthful living, preventive care, and active self-management of health
conditions
Shawnee Alliance for Seniors
Second Act – a free program sponsored by SIH for active adults age 50 or beyond. The program
engages participants in healthy living through health education, social activities, referral and
resource information related to health care issues, insurance counseling, and assistance with
understanding a living will and durable power of attorney for health care.
American Cancer Society – collaborate to provide free colonoscopies for low-income patients
and support/awareness for smoking reduction.
Integrate and expand initiatives to optimize care transitions
Illinois Transitional Care Consortium (Bridge Model)
Address needs of older adults transitioning from the hospital to the community by linking hospital-based
services with the aging network through intensive care coordination (increase quality of life, reduction in
readmissions for targeted diseases). The Bridge Model, a hospital-community partnership in a social
work transitional care model serve adults 60 years and older (expand to persons with disabilities under
age 60) is used. Community partners include Aging Care Connections, Shawnee Alliance for Seniors, and
Solutions for Care. Hospital partners include Rush University Medical Center, MacNeil Hospital,
Adventist LaGrange Memorial Hospital, Herrin Hospital and Carbondale Memorial Hospital. Research
and evaluation partners include University of Illinois at Chicago, School of Public Health, and the Health
& Medicine Policy Research Group.
61
Coleman Care Transitions
Improve patient transitions from one care setting to another; includes a four-week process that engages
patients in taking a more active role in their health care. Focuses on patient tools and skill building
(focuses on medication self-management, primary and specialist follow-up, understanding “red flag”
indicators of worsening conditions, and use of a patient health record), reinforced by a transition coach
(nurse, social worker, or trained volunteer) who follow patients across settings for the first four weeks
after a hospital discharge. Research has shown that through using this type of model, hospital costs can
be reduced and in addition, people who have used the care transitions model rate their hospital
discharge experience as very good or excellent.
62
Access to Care
INITIATIVES
Ensure access to care for persons with mental illnesses and substance abuse disorders
Mental Health Emergency Stabilization Center – date TBD
Behavioral/Mental Health “crisis hotline” and ED screening: SIH and H-Group collaborate to
provide rapid access crises services for patients with behavioral/mental health needs presenting
in local emergency departments
H-Group: Behavioral/Mental Health Open Access – innovative scheduling approach to alleviate
wait time for patients seeking care
SI Behavioral Health Consortium convened by CRHSSD
CRHSSD provides professional development regarding bullying and suicide prevention; promote
transportation access through Rural Medicine Transportation Network; technical assistance,
pursue funding opportunities, and evaluation assistance.
SIU Student Health: Restructured behavioral health service delivery by combining the counseling
center, mental health services, and wellness counseling to improve efficiency and reduce wait
time to first appointment. Incorporate “alcohol.edu,” a software intervention program, into the
University’s new student orientation; Rewrote core survey for drug and alcohol usage
measurement; promote alcohol free campus events (tailgating) and counter-marketing and
harm-reduction strategies for community drinking events; Implemented new sanctions program
requiring students arrested for drug/alcohol offenses to pay for 3 educational sessions.
Bi-County Health Dept.: Mental health referrals to H-Group/Shawnee Behavioral Health Centers;
participate in Joint Access to Care Action Team
Jackson County Health Dept.: Provide access (funding) to HIV positive individuals for mental
health services; conduct prenatal depression screenings on WIC clients. Refer WIC clients to
mental health services; participate in conducting needs assessment regarding mental health
access with Joint Access to Care Team. Health promotion messaging regarding
drinking/impaired driving and designated driver program.
Perry County: behavioral/mental health counseling incorporated into clinic visits; maintain
collaboration with Perry Counseling Center to provide behavioral health services.
Ensure access to primary/preventive dental care.
Oral Health Referral Initiative: SIH, Shawnee Health Service, SIU Community Dental Center
collaborate through a joint referral system to provide same or next day access for patients with
dental needs presenting in local emergency departments
SIUC Head Start: Works to ensure that every child enrolled in the SIUC Head Start program has
an annual dental exam; Implement a fluoride varnish program to apply fluoride varnish on
children’s teeth two times each program year; Have children brush their teeth once a day at
school; maintain a provider list to share with families needing to find a dentist; assist
transporting children to dental appointments; Collect and share data with IDPH; OHS, and other
stakeholders. Participate in Joint Access to Care Action Team; support children’s mental health
needs through referral process, limited use of a mental health consultant available.
SIU Student Health: Free dental exams for SIU students (including X-RAYS); Participate in
community screenings, creating mouthpieces for sports, etc.
63
Jackson County Health Dept.: Engaged with HCC Joint Access to Care Team; Collect and analyze
school dental health data; providing dental health education in WIC; inclusion of dental health in
community events; providing access (funding) to dental care for HIV positive individuals
Bi-County Health Dept.: Engaged with HCC Joint Access to Care Team ; Provide dental health
education through WIC program and presentations in schools; training staff to implement
fluoride varnish program
Early Head Start-Williamson County: provides fluoride varnish program
Perry County: Child-Bright Smiles Program
Shawnee Health Service, CHESI CRHPC: operate community dental centers; provide safety net
dental care
Create-A-Smile Thrift Store: helps pay for limited dental care for qualified clients
Engage with Healthy Communities Coalitions to promote and facilitate access to care
Healthy Communities Coalition: Joint Access to Care Team focus on dental and
behavioral/mental health in Southern Illinois; Behavioral Health Action Team authors regular
newspaper column focusing on mind and body health (please see full description of Healthy
Communities Coalitions under High Impact Clinical and Preventive Services).
Promote health equity through policy and advocacy
Medical Legal Partnership SI: address the effects of poverty on health through a collaborative
effort; provide legal assistance to low-income and underinsured adults seeking medical care.
This ongoing medical-legal collaboration between Land of Lincoln Legal Services and Southern
Illinois Healthcare addresses many of the social issues faced by patients contributing to their
health care needs. Legal assistance is made available to patients on-site at a clinic or hospital
in the areas of public benefits, disability, family, housing and consumer issues.
Promote/communicate currently available resources
Recreational and Youth Services: Partners: Boys and Girls Club of Carbondale, Carbondale Park
District, local health departments and schools
Illinois 211: United Way of Southern Illinois is engaged in an effort to establish regional
emergency communications
The Place – resource center. Grand opening Mar/April 2013
Collaborate to support non-emergency medical transportation
Non-emergency medical transportation: SIU Center for Rural Health and Social Service
Development, SIH, and other community partners are exploring opportunities for improved
transportation access through Rural Medicine Transportation Network
64
Quality and Effectiveness of Care
INITIATIVES
Pursue health equity by reducing variations in care
Cardiac Management Center (CHF Clinic/Get with the Guidelines)
Premier's Partnership for Patients
Preventing Readmissions Through Effective Partnerships (PREP)
Expand ED care planning for high risk/vulnerable populations
Case management care planning initiatives
Optimize care transitions through expansion of community case management models
Illinois Transitional Care Consortium (Bridge Model): Address needs of older adults transitioning
from the hospital to the community by linking hospital-based services with the aging network
through intensive care coordination (increase quality of life, reduction in readmissions for
targeted diseases). The Bridge Model, a hospital-community partnership in a social work
transitional care model serve adults 60 years and older (expand to persons with disabilities
under age 60) is used. Community partners include Aging Care Connections, Shawnee Alliance
for Seniors, and Solutions for Care. Hospital partners include Rush University Medical Center,
MacNeil Hospital, Adventist LaGrange Memorial Hospital, Herrin Hospital and Carbondale
Memorial Hospital. Research and evaluation partners include University of Illinois at Chicago,
School of Public Health, and the Health & Medicine Policy Research Group.
Coleman Care Transitions: Improve patient transitions from one care setting to another;
includes a four-week process that engages patients in taking a more active role in their health
care. Focuses on patient tools and skill building (focuses on medication self-management,
primary and specialist follow-up, understanding “red flag” indicators of worsening conditions,
and use of a patient health record), reinforced by a transition coach (nurse, social worker, or
trained volunteer) who follow patients across settings for the first four weeks after a hospital
discharge. Research has shown that through using this type of model, hospital costs can be
reduced and in addition, people who have used the care transitions model rate their hospital
discharge experience as very good or excellent.
Integrate initiatives to improve communication and care transitions
Coordinated post-acute care patient follow-up to link with primary care (no primary medical
home)
Ortho/Joint Camp: Patient/care giver education, early ambulation program, and "ready for
discharge" home simulation experience
Prairie Heart: CHF Patients/outpatient infusion therapy
Southern Illinois Parish Nurse Network (SIPNN) – CHF caregiver education
IT system integration for efficient and effective discharge planning
Patient, family, caregiver engagement in discharge planning
Engage skilled-nursing facilities in care planning and palliative care processes
Expand engagement with nursing home partners to reduce avoidable readmissions.
65
Behavioral Risk Factors
INITIATIVES
Identify and engage key leaders for at risk populations and partner to develop culturally appropriate
strategies to promote healthy lifestyles and prevention behaviors
Project Power
Project POWER is a program developed by the American Diabetes Association for African
American church congregations. The overall goal of Project POWER is to educate about and
prevent new cases of diabetes in the African American community. In addition, it is designed to
teach those who are living with diabetes how to care for themselves. The nine churches
currently participating in Project POWER include: Praise Central Church of Deliverance
(Carbondale), Faith Temple Church of God in Christ (Carbondale), New Zion Missionary Baptist
Church (Carbondale), Rock Hill Missionary Baptist Church (Carbondale), Hopewell Missionary
Baptist Church (Carbondale), March of Faith (Carbondale), Mt. Olive Baptist Church (Colp), New
Birth Kingdom International (Carbondale)
Promote inclusion of health-related activities in non-traditional settings (e.g., churches & faith-based
organizations)
Health Ministry
The Health Ministry program is administered through the Community Benefits Department of SIH.
Staff works with area faith communities to promote health and wellness through a compassionate
and holistic care approach that addresses physical, psychosocial and spiritual needs.
Southern Illinois Parish Nurse Network
Parish nurses/faith community: engage vulnerable populations with health promotion and
education regarding healthful living, preventive care, and active self-management of health
conditions
Spiritual Homebound Visitor Program
The Spiritual Homebound Program trains volunteers to address the special needs of the sick and
homebound members of their faith community with confidence and sensitivity. It also addresses a
volunteer’s own communication skills and stress management techniques.
Promote availability of healthy food choices in schools, worksites and neighborhoods
Coordinated School Health: CATCH on to Health! (Coordinated Approach To Child Health)
promotes physical activity, healthy food choices and tobacco prevention in elementary school
aged children. Partners: CHRSSD, Jackson County Health Dept., Franklin-Williamson Bi-county
Health Dept., SIH. School districts currently participating include Giant City, Desoto, Unity Point,
Carbondale Elementary District 95, St. Andrews, Johnston City, Northside Elementary – Herrin,
Christopher, New Simpson Hill, Buncombe, Creal Springs, Benton Grade School, St. John’s
Catholic School – West Frankfort, Crab Orchard, DuQuoin, Elverado, General John A. Logan
Murphysboro, Prairie DuRocher, and St. Bruno’s – Pinckneyville.
SIUC Head Start: Complete nutrient analysis on cycle menus to ensure children’s nutritional
needs are met; Nutrition education to children and families. Share written information through
our employee wellness program to staff.
Carbondale Park District: administer gardening workshops and provide community garden
space for agencies that serve children (i.e. Boys and Girls Club of Carbondale and Kid’s Korner);
supports local food partners, increase access to and reinforce the value of fresh foods; limit
sugar intake for children who participate in CPKD programs.
66
Jackson County Health Dept.: Parenting, nutrition, and exercise counseling education to WIC
clients; promotion and support of breastfeeding-WIC peer counselors, breast pumps.
Perry County: Nutrition classes
Promote physical activity
Start! Walking paths: SIH is a regional sponsor of the American Heart Association’s Start!
Walking paths in the local community.
Coordinated School Health – see description above
Kohl’s Cares For Kids: Through Memorial Hospital of Carbondale, funds received through the
program are used to educate local school students and their families about the importance of
physical activity and healthy eating for a lifetime of wellness. The Kohl’s Movers and Shakers
program focuses on increasing physical activity levels of school age children through physical
education curriculum and family education.
School districts currently participating in the Kohl’s Movers and Shakers Program include
Carbondale High School, Carbondale District 95, Desoto Grade School, Giant City School and
Unity Point School.
SIUC Head Start: Implement I am Moving, I am Learning, and CATCH for pre-k; assess children’s
height, weight, BMI data 3 times throughout each program year
SIU Student Health: Promotion of physical activity through “The Rec” Center programming.
Perry County: Developed START! Walking Path
Carbondale Park District: Utilize CATCH in children’s programs and summer camp; Hop sports
system is used by community schools
Engage the community to support tobacco-free environments
Illinois Tobacco-free communities
Employee Wellness (smoking cessation) incentives
SIH System Tobacco free campuses
SIU Student Health: Working with asthma advisory group to address smoking policies on
university campus and attempt to create smoke free areas.
Illinois Tobacco Quit Line
FWHCC: Healthy Living Action Team; Smoke-free Illinois Empowerment with local high schools
Carbondale Park District: Limit public smoking in parks; support community events which
address these challenges-provide alternative recreation opportunities.
Promote awareness of currently available resources
Healthy SI Delta Network: policies, systems and environmental supports for health, community
engagement, education, health promotion, resource sharing
We Choose Health Community Transformation Grant
Healthy Communities Coalitions: Healthy Lifestyles Action Team; Diabetes Today Resource Team
HCC: Healthy Weight Collaborative- educational tool kits to primary care providers to help
effectively address childhood obesity during a clinic visit
67
Cancer Disparities
INITIATIVES
Engage community in prevention focus (through reduction in behavioral risk factors)
See Behavioral Risk Factors related to 1) Promote availability of healthy food choices in schools,
worksites and neighborhoods; 2) Promote physical activity; 3) Engage the community to support
tobacco-free environments
Promote screening and early detection
Prevention/detection
SIH employee health coaches
Smoking cessation
Lung Cancer awareness
Prostate screening
Skin screening
Skin cancer awareness
Nutritional education
Weight control program
Breast cancer risk assessment/prevention
Community Outreach
Smoking cessation
Breast Self-exam education/training
Buddy Check 9 – breast health awareness kit
Screening mammography
Reduced cost screening (mammography and colorectal)
Increase community member’s knowledge of available support resources.
Psychosocial and support services
Breast Health Patient Navigator
GI, Lung & Colorectal Patient Navigator
Head/neck Patient Navigator
Women with Hope – support group for cancer survivors and family members.
Palliative care program
Pain management
Patient resource center
Pastoral care
PT/OT, lymphedema therapy
Referrals
Patient, family and caregiver illness counseling
Home care program
Hospice
Cancer support groups
ACS programs: LGFB, Reach to Recovery, Road to Recovery, Man to Man
68
Pursue strategic alliances with complementary community state and national partners to reduce the
burden of cancer in Southern Illinois
Collaboration between Simmon’s Cancer Institute -SIU School of Medicine, SIH, HSIDN, and
CHRSSD to reduce lung cancer disparities in rural southern Illinois
o Lung Nodule Clinic
o Community-based Participatory Research
Addressing Cancer Disparities in Central and Southern Illinois – collaboration between SIU SOM,
SIH, and HSIDN; coalition engagement to help reduce the burden of cancer in downstate Illinois;
including smoking cessation intervention deployment. Beginning summer 2013 pending funding.
Illinois Cancer Partnership (ICP) – works toward goal of chronic disease integration by
encouraging cooperation among programs and seeks to coordinate efficient utilization of limited
resources by encouraging cooperation among categorical programs, like cancer control; and
exploring opportunities to leverage resources from other programs that can complement ICP
goals. The ICP is engaged in an intensive strategy development and planning process for the
Illinois Comprehensive Cancer Control Plan in partnership with the other chronic disease
programs utilizing the “World Café” model.
American Cancer Society – collaboration to provide free-colonoscopies to qualified clients
Partnerships: Harrisburg Medical Center, Marshall Browning Hospital, Shawnee Alliance
Coordinated School Health
Faith community/parish nurses
Health Communities Coalitions
Healthy Southern Illinois Delta Network (HSIDN)
69
Areas Not Directly Addressed
Through the needs assessment additional areas were identified as important and clearly impact the
health of the community. However, because of the numerous unmet needs already addressed in this
implementation plan, topics that are deemed to have less immediate impact or topics in which other
community partners and stakeholders either already directly address or have implementation plans to
address are not integrated into this plan. Although the following areas are not directly addressed in this
implementation plan, should the opportunity arise, additional areas could be incorporated in the future.
Alcohol/Substance Abuse and Addiction
The most notable health needs not addressed at this time are alcohol, substance abuse and related
addiction. Although this topic is often paired with Mental Health, SIH’s priority focus at this time is the
behavioral/mental health diagnoses (such as depression and anxiety). Every effort will be made to assist
area providers in maintaining and/or expanding the services that they currently provide.
Economy/Unemployment/Poverty
Although high unemployment has personal and societal impacts, Southern Illinois Healthcare does not
have the resources that would be required to effect the changes that are needed to adequately address
this area. SIH will, however, continue to explore potential partnerships and internal strategies to
positively impact our patients and community; and will work within existing structures to ensure access
to healthy foods and health services for our most vulnerable populations.
Education/graduation Rates
Southern Illinois Healthcare does not have the resources that would be required to effect the changes
that are needed to adequately address this area. However, we will continue to explore potential
partnerships and internal strategies to positively impact our patients and community. In addition, SIH
will continue to offer mentoring and internship programs for high school and college students, as well as
tuition assistance and professional development opportunities for our 3000+ employees.
HIV and Sexually Transmitted Infections
Community partners, local health departments and SIU Student Health Center are aggressively
addressing this topic through individual efforts, collaboration of the Healthy Communities Coalition
Sexual Health Action Team and HIV Care Connect. SIH will continue to share information as needed and
partner as requested to provide essential services to our community.
Suicide
This topic is being addressed indirectly through the planned Emergency Mental Health Outpatient
Stabilization Facility. SIH utilization patterns suggest access/barriers to ambulatory, outpatient and
other less intensive services or a failure to access treatment until the individual’s need has risen to a
more critical level. Intervening earlier to de-escalate crises, should contribute to better mental health in
the community, thereby reducing suicide rates. Every effort will be made to assist area providers in
maintaining and/or expanding the services that they currently provide.
Transportation
Non-emergency medical transportation has been identified as a need. However, at this time most of the
available data is anecdotal in nature. SIH will continue to explore potential opportunities in this area
and work with the SIU Center for Rural Health and Social Service Development to obtain quantifiable
support and actionable strategies to incorporate in future plans.
70

Memorial Hospital of Carbondale

Transcription

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